Sex and organ-specific risk of major adverse renal or cardiac events in solid organ transplant recipients with COVID-19

被引:19
作者
Vinson, Amanda J. [1 ]
Dai, Ran [2 ]
Agarwal, Gaurav [3 ]
Anzalone, Alfred J. [2 ]
Lee, Stephen B. [4 ]
French, Evan [5 ]
Olex, Amy L. [5 ]
Madhira, Vithal [6 ]
Mannon, Roslyn B. [7 ]
机构
[1] Dalhousie Univ, Dept Med, Div Nephrol, Halifax, NS, Canada
[2] Univ Nebraska Med Ctr, Dept Biostat, Omaha, NE USA
[3] Univ Alabama Birmingham, Dept Med, Div Nephrol, Birmingham, AL 35294 USA
[4] Univ Saskatchewan, Div Infect Dis Regina, Saskatoon, SK, Canada
[5] Virginia Commonwealth Univ, Wright Ctr Clin & Translat Res, Richmond, VA USA
[6] Palila Software, Reno, NV USA
[7] Univ Nebraska Med Ctr, Dept Med, Div Nephol, Omaha, NE USA
关键词
age; allograft type; cardiac; COVID-19; gender; heart; infection; kidney; liver; lung; MACE; MARCE; mortality; outcome; SARS-CoV-2; sex; solid organ transplantation; KIDNEY-TRANSPLANT; INFECTIOUS COMPLICATIONS; DIALYSIS PATIENTS; MORTALITY; EPIDEMIOLOGY; CANDIDATES; REGISTRY; IMPACT;
D O I
10.1111/ajt.16865
中图分类号
R61 [外科手术学];
学科分类号
摘要
While older males are at the highest risk for poor coronavirus disease 2019 (COVID-19) outcomes, it is not known if this applies to the immunosuppressed recipient of a solid organ transplant (SOT), nor how the type of allograft transplanted may impact outcomes. In a cohort study of adult (>18 years) patients testing positive for COVID-19 (January 1, 2020-June 21, 2021) from 56 sites across the United States identified using the National COVID Cohort Collaborative (N3C) Enclave, we used multivariable Cox proportional hazards models to assess time to MARCE after COVID-19 diagnosis in those with and without SOT. We examined the exposure of age-stratified recipient sex overall and separately in kidney, liver, lung, and heart transplant recipients. 3996 (36.4%) SOT and 91 646 (4.8%) non-SOT patients developed MARCE. Risk of post-COVID outcomes differed by transplant allograft type with heart and kidney recipients at highest risk. Males with SOT were at increased risk of MARCE, but to a lesser degree than the non-SOT cohort (HR 0.89, 95% CI 0.81-0.98 for SOT and HR 0.61, 95% CI 0.60-0.62 for non-SOT [females vs. males]). This represents the largest COVID-19 SOT cohort to date and the first-time sex-age-stratified and allograft-specific COVID-19 outcomes have been explored in those with SOT.
引用
收藏
页码:245 / 259
页数:15
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