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COVID-19-related mortality in kidney transplant and haemodialysis patients: a comparative, prospective registry-based study.
Goffin, Eric; Candellier, Alexandre; Vart, Priya; Noordzij, Marlies; Arnol, Miha; Covic, Adrian; Lentini, Paolo; Malik, Shafi; Reichert, Louis J; Sever, Mehmet S; Watschinger, Bruno; Jager, Kitty J; Gansevoort, Ron T.
  • Goffin E; Department of Nephrology, Cliniques Universitaires Saint-Luc, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium.
  • Candellier A; Department of Nephrology, Cliniques Universitaires Saint-Luc, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium.
  • Vart P; Department of Nephrology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France.
  • Noordzij M; Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Arnol M; Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Covic A; Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
  • Lentini P; Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, 'Grigore T. Popa' University of Medicine, Iasi, Romania.
  • Malik S; Nephrology and Dialysis Unit, San Bassiano Hospital, Vicenza, Italy.
  • Reichert LJ; Department of Renal and Transplant, University Hospital of Coventry and Warwickshire and University of Leicester, Coventry, UK.
  • Sever MS; Department of Nephrology, Rijnstate Hospital, Arnhem, The Netherlands.
  • Watschinger B; Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
  • Jager KJ; Department of Nephrology, Medical University of Vienna, Vienna, Austria.
  • Gansevoort RT; Department of Medical Informatics, ERA-EDTA Registry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Nephrol Dial Transplant ; 36(11): 2094-2105, 2021 11 09.
Article in English | MEDLINE | ID: covidwho-1511006
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has exposed haemodialysis (HD) patients and kidney transplant (KT) recipients to an unprecedented life-threatening infectious disease, raising concerns about kidney replacement therapy (KRT) strategy during the pandemic. This study investigated the association of the type of KRT with COVID-19 severity, adjusting for differences in individual characteristics.

METHODS:

Data on KT recipients and HD patients diagnosed with COVID-19 between 1 February 2020 and 1 December 2020 were retrieved from the European Renal Association COVID-19 Database. Cox regression models adjusted for age, sex, frailty and comorbidities were used to estimate hazard ratios (HRs) for 28-day mortality risk in all patients and in the subsets that were tested because of symptoms.

RESULTS:

A total of 1670 patients (496 functional KT and 1174 HD) were included; 16.9% of KT and 23.9% of HD patients died within 28 days of presentation. The unadjusted 28-day mortality risk was 33% lower in KT recipients compared with HD patients {HR 0.67 [95% confidence interval (CI) 0.52-0.85]}. In a fully adjusted model, the risk was 78% higher in KT recipients [HR 1.78 (95% CI 1.22-2.61)] compared with HD patients. This association was similar in patients tested because of symptoms [fully adjusted model HR 2.00 (95% CI 1.31-3.06)]. This risk was dramatically increased during the first post-transplant year. Results were similar for other endpoints (e.g. hospitalization, intensive care unit admission and mortality >28 days) and across subgroups.

CONCLUSIONS:

KT recipients had a greater risk of a more severe course of COVID-19 compared with HD patients, therefore they require specific infection mitigation strategies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 / Kidney Failure, Chronic Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Nephrol Dial Transplant Journal subject: Nephrology / Transplantation Year: 2021 Document Type: Article Affiliation country: Ndt

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 / Kidney Failure, Chronic Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Nephrol Dial Transplant Journal subject: Nephrology / Transplantation Year: 2021 Document Type: Article Affiliation country: Ndt