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COVID-19 severity in kidney transplant recipients is similar to nontransplant patients with similar comorbidities |
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| Authors: | Nathalie Chavarot Juliette Gueguen Guillaume Bonnet Mariam Jdidou Antonin Trimaille Carole Burger Lucile Amrouche Orianne Weizman Thibaut Pommier Olivier Aubert Joffrey Celier Rebecca Sberro-Soussan Laura Geneste Vassili Panagides Michel Delahousse Wassima Marsou Claire Aguilar Antoine Deney Julien Zuber Charles Fauvel Christophe Legendre Delphine Mika Theo Pezel Dany Anglicheau Willy Sutter Mohamad Zaidan Renaud Snanoudj Ariel Cohen Anne Scemla for the Critical COVID- France Investigators |
| Institution: | 1. Départment de Néphrologie et transplantation rénale, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France;2. Université de Paris, Paris, France
Paris Translational Research Centre for Organ Transplantation, PARCC, INSERM, Paris, France;3. Département de Néphrologie et transplantation, Hôpital Foch, Suresnes;4. Nouvel Hôpital Civil, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France;5. Départment de Néphrologie et transplantation rénale, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Université de Paris, Paris, France;6. Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-Les-Nancy, France;7. Centre Hospitalier Universitaire de Dijon, Dijon, France;8. Université de Paris, Paris, France;9. Hôpital Européen Georges Pompidou, Université de Paris, Paris, France;10. Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens, France;11. Centre Hospitalier Universitaire de Marseille, Marseille, France;12. GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille, Faculté de Médecine et de Maïeutique, Université Catholique de Lille, Lille, France;13. Université de Paris, Paris, France Départment de maladies infectieuses et tropicales, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France;14. Centre Hospitalier Universitaire de Toulouse, Toulouse, France;15. Centre Hospitalier Universitaire de Rouen, FHU REMOD-VHF, Rouen, France;16. Université Paris-Saclay, Inserm, UMR-S 1180, Chatenay-Malabry, France;17. Hôpital Lariboisière, APHP, University of Paris, Paris, France;18. Département de Néphrologie et transplantation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France;19. Université de Paris, Paris, France Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France |
| Abstract: | Higher rates of severe COVID-19 have been reported in kidney transplant recipients (KTRs) compared to nontransplant patients. We aimed to determine if poorer outcomes were specifically related to chronic immunosuppression or underlying comorbidities. We used a 1:1 propensity score-matching method to compare survival and severe disease-free survival (defined as death and/or need for intensive care unit ICU]) incidence in hospitalized KTRs and nontransplant control patients between February 26 and May 22, 2020. Patients were matched for risk factors of severe COVID-19: age, sex, body mass index, diabetes mellitus, preexisting cardiopathy, chronic lung disease, and basal renal function. We included 100 KTRs (median age interquartile range (IQR)]) 64.7 years (55.3–73.1) in three French transplant centers. After a median follow-up of 13 days (7–30), transfer to ICU was required for 34 patients (34%) and death occurred in 26 patients (26%). Overall, 43 patients (43%) developed a severe disease during a median follow-up of 8.5 days (2–14). Propensity score matching to a large French cohort of 2017 patients hospitalized in 24 centers, revealed that survival was similar between KTRs and matched nontransplant patients with respective 30-day survival of 62.9% and 71% (p = .38) and severe disease-free 30-day survival of 50.6% and 47.5% (p = .91). These findings suggest that severity of COVID-19 in KTRs is related to their associated comorbidities and not to chronic immunosuppression. |
| Keywords: | clinical research / practice infection and infectious agents infection and infectious agents - viral kidney transplantation / nephrology |