Author(s): de Sandes-Freitas, Tainá Veras ; de Andrade, Luís Gustavo Modelli [UNESP] ; Moura, Lucio Roberto Requião ; Cristelli, Marina Pontello ; Medina-Pestana, José Osmar ; Lugon, Jocemir Ronaldo ; Sesso, Ricardo
Date: 2022
Persistent ID: http://hdl.handle.net/11449/231539
Origin: Oasisbr
Subject(s): COVID-19; Kidney transplantation; Propensity score; Renal dialysis
Made available in DSpace on 2022-04-29T08:46:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01
Background and objectives: Patients undergoing kidney replacement therapies (KRTs) have a poor prognosis after Covid-19 infection. Few studies have compared the outcomes of such patients in the different KRT modalities. This study aimed to analyze the 30-day Covid-19-associated case-fatality rate of dialysis and kidney transplant patients. Methods: Retrospective cohort study analyzing data from patients with confirmed Covid-19 between Mar/20 and Jan/21 included in two multicenter studies, the Brazilian Covid-19 Dialysis Study (Dialysis group, n = 703) and the Covid-19-KT Brazilian Study (Transplant group, n = 1907). To assess the risk factors for death, adjusted Cox hazards models were used. A sensitivity analysis was performed using a propensity score analysis to match the groups (n = 587 patients in each group). Results: A higher percentage of transplant patients required hospitalization (68 vs. 51%, p < 0.001), intensive care (37 vs. 30%, p = 0.023), and invasive mechanical ventilation (28 vs. 22%, p = 0.035). Multivariate analysis of the before-matching sample showed that subjects in the transplant group were at a lower death risk at baseline (HR 0.380.560.85). However, they showed higher risk over time (HR 1.031.061.09). Kaplan–Meier analysis after propensity score matching confirmed the inferior 30-day cumulative survival in the transplant recipients (83 vs. 78%, p = 0.0014). Conclusion: Both transplant and dialysis patients have high 30-day case-fatality rates after a Covid-19 diagnosis. Despite lower death risk at baseline, transplant patients have an increased death risk of 6% per day than dialysis patients. Graphical Abstract: [Figure not available: see fulltext.]
Programa de Pós-Graduação Em Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina Universidade Federal Do Ceará, CE
Hospital Universitário Walter Cantídio, CE
Hospital Geral de Fortaleza, CE
Departamento de Medicina Interna Universidade Estadual Paulista-UNESP, SP
Hospital Do Rim Fundação Oswaldo Ramos, SP
Departamento de Medicina Disciplina de Nefrologia Universidade Federal de São Paulo. Rua Botucatu, 740, SP
Unidade de Transplante Renal Hospital Israelita Albert Einstein, SP
Departamento de Medicina Divisão de Nefrologia Universidade Federal Fluminense, RJ
Departamento de Medicina Interna Universidade Estadual Paulista-UNESP, SP
