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A Comparison Study of Coronavirus Disease 2019 Outcomes in Hospitalized Kidney Transplant Recipients.
Mansour, Sherry G; Malhotra, Divyanshu; Simonov, Michael; Yamamoto, Yu; Arora, Tanima; Subair, Labeebah; Alausa, Jameel; Moledina, Dennis G; Greenberg, Jason H; Wilson, Francis Perry; Marin, Ethan P.
  • Mansour SG; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Malhotra D; Section of Nephrology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
  • Simonov M; Section of Nephrology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
  • Yamamoto Y; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Arora T; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Subair L; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Alausa J; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Moledina DG; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Greenberg JH; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
  • Wilson FP; Section of Nephrology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
  • Marin EP; Department of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut.
Kidney360 ; 2(3): 494-506, 2021 03 25.
Article in English | MEDLINE | ID: covidwho-1776875
ABSTRACT

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect any human host, but kidney transplant recipients (KTR) are considered more susceptible on the basis of previous experience with other viral infections. We evaluated rates of hospital complications between SARS-CoV-2-positive KTR and comparator groups.

Methods:

We extracted data from the electronic health record on patients who were hospitalized with SARS-CoV-2, testing at six hospitals from March 4 through September 9, 2020. We compared outcomes between SARS-CoV-2-positive KTR and controls SARS-CoV-2-positive non-KTR, SARS-CoV-2-negative KTR, and SARS-CoV-2-negative non-KTR.

Results:

Of 31,540 inpatients, 3213 tested positive for SARS-CoV-2. There were 32 SARS-CoV-2-positive and 224 SARS-CoV-2-negative KTR. SARS-CoV-2-positive KTR had higher ferritin levels (1412; interquartile range, 748-1749 versus 553; interquartile range, 256-1035; P<0.01) compared with SARS-CoV-2-positive non-KTR. SARS-CoV-2-positive KTR had higher rates of ventilation (34% versus 14%, P<0.01; versus 9%, P<0.01; versus 5%, P<0.01), vasopressor use (41% versus 16%, P<0.01; versus 17%, P<0.01; versus 12%, P<0.01), and AKI (47% versus 15%, P<0.01; versus 23%, P<0.01; versus 10%, P<0.01) compared with SARS-CoV-2-positive non-KTR, SARS-CoV-2-negative KTR, and SARS-CoV-2-negative non-KTR, respectively. SARS-CoV-2-positive KTR continued to have increased odds of ventilation, vasopressor use, and AKI compared with SARS-CoV-2-positive non-KTR independent of Elixhauser score, Black race, and baseline eGFR. Mortality was not significantly different between SARS-CoV-2-positive KTR and non-KTR, but there was a notable trend toward higher mortality in SARS-CoV-2-positive KTR (25% versus 16%, P=0.15, respectively).

Conclusions:

Hospitalized SARS-CoV-2-positive KTR had a high rate of mortality and hospital complications, such as requiring ventilation, vasopressor use, and AKI. Additionally, they had higher odds of hospital complications compared with SARS-CoV-2-positive non-KTR after adjusting for Elixhauser score, Black race, and baseline eGFR. Future studies with larger sample size of KTR are needed to validate our findings. Podcast This article contains a podcast at https//dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/K360/2021_03_25_KID0005652020.mp3.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Kidney360 Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Kidney360 Year: 2021 Document Type: Article