tetano
Editor, Senior Moderator
Transpl Int
. 2022 Feb 1;36:10205.
doi: 10.3389/ti.2022.10205. eCollection 2022.
Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study
Tainá Veras de Sandes-Freitas[SUP] 1 2 3 [/SUP], Marina Pontello Cristelli[SUP] 4 [/SUP], Lucio Roberto Requião-Moura[SUP] 4 5 6 [/SUP], Luís Gustavo Modelli de Andrade[SUP] 7 [/SUP], Laila Almeida Viana[SUP] 4 [/SUP], Valter Duro Garcia[SUP] 8 [/SUP], Claudia Maria Costa de Oliveira[SUP] 2 [/SUP], Ronaldo de Matos Esmeraldo[SUP] 3 [/SUP], Paula Roberta de Lima[SUP] 1 [/SUP], Ida Maria Maximina Fernandes Charpiot[SUP] 9 [/SUP], Teresa Cristina Alves Ferreira[SUP] 10 [/SUP], Rodrigo Fontanive Franco[SUP] 11 [/SUP], Kellen Micheline Alves Henrique Costa[SUP] 12 [/SUP], Denise Rodrigues Simão[SUP] 13 [/SUP], Gustavo Fernandes Ferreira[SUP] 14 [/SUP], Viviane Brandão Bandeira de Mello Santana[SUP] 15 [/SUP], Ricardo Augusto Monteiro de Barros Almeida[SUP] 7 [/SUP], Luciane Monica Deboni[SUP] 16 [/SUP], Anita Leme da Rocha Saldanha[SUP] 17 [/SUP], Irene de Lourdes Noronha[SUP] 17 18 [/SUP], Lívia Cláudio de Oliveira[SUP] 19 [/SUP], Deise De Boni Monteiro de Carvalho[SUP] 20 [/SUP], Reinaldo Barreto Oriá[SUP] 1 [/SUP], Jose Osmar Medina-Pestana[SUP] 4 5 [/SUP], Helio Tedesco-Silva Junior[SUP] 4 5 [/SUP]
Affiliations
Abstract
Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1: <72 days; Q2: 72-104 days; Q3: 105-140 days; Q4: >140 days after the index case). The 28-day fatality decreased from 29.5% (Q1) to 18.8% (Q4) (p [SUB]for-trend[/SUB] = 0.004). In multivariable analysis, patients diagnosed in Q4 showed a 35% reduced risk of death. The trend of reducing fatality was associated with a lower number of comorbidities (20.7-10.6%, p [SUB]for-trend[/SUB] = 0.002), younger age (55-53 years, p [SUB]for-trend[/SUB] = 0.062), and better baseline renal function (43.6-47.7 ml/min/1.73 m[SUP]2[/SUP], p [SUB]for-trend[/SUB] = 0.060), and were confirmed by multivariable analysis. The proportion of patients presenting dyspnea (p [SUB]for-trend[/SUB] = 0.001) and hypoxemia (p [SUB]for-trend[/SUB] < 0.001) at diagnosis, and requiring intensive care was also found reduced (p [SUB]for-trend[/SUB] = 0.038). Despite possible confounding variables and time-dependent sampling differences, we conclude that COVID-19-associated fatality decreased over time. Differences in demographics, clinical presentation, and treatment options might be involved.
Keywords: Covid-19; Sars-CoV-2; coronavirus; kidney transplant; renal transplantation.
. 2022 Feb 1;36:10205.
doi: 10.3389/ti.2022.10205. eCollection 2022.
Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study
Tainá Veras de Sandes-Freitas[SUP] 1 2 3 [/SUP], Marina Pontello Cristelli[SUP] 4 [/SUP], Lucio Roberto Requião-Moura[SUP] 4 5 6 [/SUP], Luís Gustavo Modelli de Andrade[SUP] 7 [/SUP], Laila Almeida Viana[SUP] 4 [/SUP], Valter Duro Garcia[SUP] 8 [/SUP], Claudia Maria Costa de Oliveira[SUP] 2 [/SUP], Ronaldo de Matos Esmeraldo[SUP] 3 [/SUP], Paula Roberta de Lima[SUP] 1 [/SUP], Ida Maria Maximina Fernandes Charpiot[SUP] 9 [/SUP], Teresa Cristina Alves Ferreira[SUP] 10 [/SUP], Rodrigo Fontanive Franco[SUP] 11 [/SUP], Kellen Micheline Alves Henrique Costa[SUP] 12 [/SUP], Denise Rodrigues Simão[SUP] 13 [/SUP], Gustavo Fernandes Ferreira[SUP] 14 [/SUP], Viviane Brandão Bandeira de Mello Santana[SUP] 15 [/SUP], Ricardo Augusto Monteiro de Barros Almeida[SUP] 7 [/SUP], Luciane Monica Deboni[SUP] 16 [/SUP], Anita Leme da Rocha Saldanha[SUP] 17 [/SUP], Irene de Lourdes Noronha[SUP] 17 18 [/SUP], Lívia Cláudio de Oliveira[SUP] 19 [/SUP], Deise De Boni Monteiro de Carvalho[SUP] 20 [/SUP], Reinaldo Barreto Oriá[SUP] 1 [/SUP], Jose Osmar Medina-Pestana[SUP] 4 5 [/SUP], Helio Tedesco-Silva Junior[SUP] 4 5 [/SUP]
Affiliations
- PMID: 35185380
- PMCID: PMC8842378
- DOI: 10.3389/ti.2022.10205
Abstract
Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1: <72 days; Q2: 72-104 days; Q3: 105-140 days; Q4: >140 days after the index case). The 28-day fatality decreased from 29.5% (Q1) to 18.8% (Q4) (p [SUB]for-trend[/SUB] = 0.004). In multivariable analysis, patients diagnosed in Q4 showed a 35% reduced risk of death. The trend of reducing fatality was associated with a lower number of comorbidities (20.7-10.6%, p [SUB]for-trend[/SUB] = 0.002), younger age (55-53 years, p [SUB]for-trend[/SUB] = 0.062), and better baseline renal function (43.6-47.7 ml/min/1.73 m[SUP]2[/SUP], p [SUB]for-trend[/SUB] = 0.060), and were confirmed by multivariable analysis. The proportion of patients presenting dyspnea (p [SUB]for-trend[/SUB] = 0.001) and hypoxemia (p [SUB]for-trend[/SUB] < 0.001) at diagnosis, and requiring intensive care was also found reduced (p [SUB]for-trend[/SUB] = 0.038). Despite possible confounding variables and time-dependent sampling differences, we conclude that COVID-19-associated fatality decreased over time. Differences in demographics, clinical presentation, and treatment options might be involved.
Keywords: Covid-19; Sars-CoV-2; coronavirus; kidney transplant; renal transplantation.