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Predictive ability of severity scores and outcomes for mortality in kidney transplant recipients with coronavirus disease 2019 admitted to the intensive care unit: results from a Brazilian single-center cohort study.
Peruzzo, Maria Bethânia; Requião-Moura, Lúcio; Nakamura, Mônica Rica; Viana, Laila; Cristelli, Marina; Tedesco-Silva, Hélio; Medina-Pestana, José.
  • Peruzzo MB; Fundação Oswaldo Ramos, Hospital do Rim, Unidade de Terapia Intensiva, São Paulo, SP, Brasil.
  • Requião-Moura L; Fundação Oswaldo Ramos, Hospital do Rim, Unidade de Terapia Intensiva, São Paulo, SP, Brasil.
  • Nakamura MR; Fundação Oswaldo Ramos, Hospital do Rim, Departamento de Transplante, São Paulo, SP, Brasil.
  • Viana L; Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Nefrologia, São Paulo, SP, Brasil.
  • Cristelli M; Fundação Oswaldo Ramos, Hospital do Rim, Departamento de Transplante, São Paulo, SP, Brasil.
  • Tedesco-Silva H; Fundação Oswaldo Ramos, Hospital do Rim, Departamento de Transplante, São Paulo, SP, Brasil.
  • Medina-Pestana J; Fundação Oswaldo Ramos, Hospital do Rim, Departamento de Transplante, São Paulo, SP, Brasil.
J Bras Nefrol ; 44(3): 383-394, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-2054623
ABSTRACT

BACKGROUND:

the predictive ability of severity scores for mortality in patients admitted to intensive care units is not well-known among kidney transplanted (KT) patients, especially those diagnosed with coronavirus disease 2019 (COVID-19). The purpose of the present study was to evaluate the predictive ability of severity scores for mortality in KT recipients.

METHODS:

51 KT recipients with COVID-19 diagnosis were enrolled. The performance of the SOFA, SAPS 3, and APACHE IV tools in predicting mortality after COVID-19 was compared by the area under the ROC curve (AUC-ROC) and univariate Cox regression analysis was performed.

RESULTS:

The 90-day cumulative incidence of death was 63.4%. Only APACHE IV score differed between survivors and nonsurvivors 91.2±18.3 vs. 106.5±26.3, P = 0.03. The AUC- ROC of APACHE IV for predicting death was 0.706 (P = 0.04) and 0.656 (P = 0.06) at 7 and 90 days, respectively. Receiving a kidney from a deceased donor (HR = 3.16; P = 0.03), troponin levels at admission (HR for each ng/mL = 1.001; P = 0.03), APACHE IV score (HR for each 1 point = 1.02; P = 0.01), mechanical ventilation (MV) requirement (HR = 3.04; P = 0.002) and vasopressor use on the first day after ICU admission (HR = 3.85; P < 0.001) were associated with the 90-day mortality in the univariate analysis.

CONCLUSION:

KT recipients had high mortality, which was associated with type of donor, troponin levels, early use of vasopressors, and MV requirement. The other traditional severity scores investigated could not predict mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English / Portuguese Journal: J Bras Nefrol Journal subject: Nephrology Year: 2022 Document Type: Article Affiliation country: 2175-8239-JBN-2021-0155

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English / Portuguese Journal: J Bras Nefrol Journal subject: Nephrology Year: 2022 Document Type: Article Affiliation country: 2175-8239-JBN-2021-0155