In:
Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 10 ( 2020-10), p. 2413-2423
Abstract:
Although studies have found coronavirus disease 2019 (COVID-19) to be associated with high morbidity and mortality among kidney transplant recipients, risk factors for COVID-19 among kidney transplant patients remain poorly defined. In this prospective cohort study in France, the authors enrolled 1216 kidney transplant patients, 66 (5%) of whom were diagnosed with COVID-19. The mortality rate associated with COVID-19 for the overall study population was 1% and 24% among COVID-19–positive patients. Factors that were independently associated with COVID-19 included non-White race and comorbidities, including obesity, diabetes, and asthma and chronic pulmonary disease. In the context of COVID-19, it is imperative that policy makers integrate information about risk factors to help clinicians balance benefits and risks and better advise patients about potential risks. Background COVID-19 has been associated with high morbidity and mortality in kidney transplant recipients. However, risk factors for COVID-19 disease in patients with kidney transplants remain poorly defined. Methods We enrolled patients who underwent kidney transplantation and were actively followed up in two hospitals in Paris on March 1st, 2020. Patients were screened for baseline and transplant characteristics, functional parameters, comorbidities, and immunosuppressive therapies. COVID-19 disease was assessed. Patients were followed up during the pandemic until April 30th, 2020 by the COVID-19 SLS KT survey program, including teleconsulting, at-home monitoring for patients with COVID-19, and a dedicated phone hotline platform. Results Among 1216 patients with kidney transplants enrolled, 66 (5%) patients were identified with COVID-19 disease, which is higher than the incidence observed in the general population in France (0.3%). Their mean age was 56.4±12.5 years, and 37 (56%) patients were men. The following factors were independently associated with COVID-19 disease: non-White ethnicity (adjusted odds ratio [OR], 2.17; 95% confidence interval [95% CI] , 1.23 to 3.78; P =0.007), obesity (OR, 2.19; 95% CI, 1.19 to 4.05; P =0.01), asthma and chronic pulmonary disease (OR, 3.09; 95% CI, 1.49 to 6.41; P =0.002), and diabetes (OR, 3.33; 95% CI, 1.92 to 5.77; P 〈 0.001). The mortality rate related to COVID-19 disease was 1% in the overall study population and 24% in COVID-19–positive patients. Conclusions Patients with kidney transplants display a high risk of mortality. Non-White ethnicity and comorbidities such as obesity, diabetes, asthma, and chronic pulmonary disease were associated with higher risk of developing COVID-19 disease. It is imperative that policy makers urgently ensure the integration of such risk factors on response operations against COVID-19.
Type of Medium:
Online Resource
ISSN:
1046-6673
,
1533-3450
DOI:
10.1681/ASN.2020050639
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2029124-3
