Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

被引：63

作者：

Heldman, Madeleine R. ^{[1
]}

Kates, Olivia S. ^{[1
]}

Safa, Kassem ^{[2
]}

Kotton, Camille N. ^{[2
]}

Georgia, Sarah J. ^{[2
]}

Steinbrink, Julie M. ^{[3
]}

Alexander, Barbara D. ^{[3
]}

Hemmersbach-Miller, Marion ^{[4
]}

Blumberg, Emily A. ^{[5
]}

Multani, Ashrit ^{[6
]}

Haydel, Brandy ^{[7
]}

La Hoz, Ricardo M. ^{[8
]}

Moni, Lisset ^{[9
]}

Condor, Yesabeli ^{[9
]}

Flores, Sandra ^{[9
]}

Munoz, Carlos G. ^{[9
]}

Guitierrez, Juan ^{[9
]}

Diaz, Esther I. ^{[9
]}

Diaz, Daniela ^{[9
]}

Vianna, Rodrigo ^{[9
]}

Guerra, Giselle ^{[9
]}

Loebe, Matthias ^{[9
]}

Rakita, Robert M. ^{[1
]}

Malinis, Maricar ^{[10
]}

Azar, Marwan M. ^{[10
]}

Hemmige, Vagish ^{[11
]}

McCort, Margaret E. ^{[11
]}

Chaudhry, Zohra S. ^{[12
]}

Singh, Pooja P. ^{[13
]}

Hughes Kramer, Kailey ^{[14
]}

Velioglu, Arzu ^{[15
]}

Yabu, Julie M. ^{[16
]}

Morillis, Jose A. ^{[17
]}

Mehta, Sapna A. ^{[18
]}

Tanna, Sajal D. ^{[19
]}

Ison, Michael G. ^{[19
]}

Derenge, Ariella C. ^{[20
]}

van Duin, David ^{[21
]}

Maximin, Adrienne ^{[22
]}

Gilbert, Carlene ^{[23
]}

Goldman, Jason D. ^{[1
,24
]}

Lease, Erika D. ^{[25
]}

Fisher, Cynthia E. ^{[1
]}

Limaye, Ajit P. ^{[1
]}

机构：

[1] Univ Washington, Div Allergy & Infect Dis, Seattle, WA 98195 USA

[2] Massachusetts Gen Hosp, Boston, MA 02114 USA

[3] Duke Univ, Dept Med, Div Infect Dis, Durham, NC USA

[4] Baylor Coll Med, Sect Infect Dis, Houston, TX 77030 USA

[5] Univ Penn, Dept Med, Div Infect Dis, Perelman Sch Med, Philadelphia, PA 19104 USA

[6] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Infect Dis, Los Angeles, CA 90095 USA

[7] Icahn Sch Med Mt Sinai, Recanati Miller Transplantat Inst, New York, NY 10029 USA

[8] Univ Texas Southwestern Med Ctr Dallas, Div Infect Dis & Geog Med, Dallas, TX 75390 USA

[9] Univ Miami, Jackson Mem Hosp, Miami, FL 33136 USA

[10] Yale Sch Med, Dept Internal Med, Sect Infect Dis, New Haven, CT USA

[11] Montefiore Med Ctr, Albert Einstein Coll Med, Div Infect Dis, Bronx, NY 10467 USA

[12] Henry Ford Hlth Syst, Transplantat Infect Dis & Immunotherapy, Detroit, MI USA

[13] Univ New Mexico, Div Nephrol, Albuquerque, NM 87131 USA

[14] Univ Pittsburgh, Transplant Infect Dis, Pittsburgh, PA USA

[15] Marmara Univ, Sch Med, Div Nephrol, Dept Internal Med, Istanbul, Turkey

[16] Univ Calif Los Angeles, Dept Med, Div Nephrol, Los Angeles, CA 90024 USA

[17] Cleveland Clin, Dept Infect Dis, Cleveland, OH 44106 USA

[18] NYU Langone Transplant Inst, New York, NY USA

[19] Northwestern Univ, Div Infect Dis, Feinberg Sch Med, Chicago, IL 60611 USA

[20] Thomas Jefferson Univ, Dept Med, Sidney Kimmel Med Coll, Philadelphia, PA 19107 USA

[21] Univ N Carolina, Dept Med, Div Infect Dis, Chapel Hill, NC 27515 USA

[22] INTEGRIS Hlth, Oklahoma City, OK USA

[23] Banner Hlth, Phoenix, AZ USA

[24] Swedish Med Ctr, Seattle, WA USA

[25] Univ Washington, Div Pulmonol Crit Care & Sleep Med, Seattle, WA 98195 USA

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2022年 / 22卷 / 01期

关键词：

clinical research; practice; infection and infectious agents; viral; infectious disease; organ transplantation in general; quality of care; care delivery;

D O I：

10.1111/ajt.16840

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Mortality among patients hospitalized for COVID-19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID-19, we compared 28-day mortality between early 2020 (March 1, 2020-June 19, 2020) and late 2020 (June 20, 2020-December 31, 2020). Multivariable logistic regression was used to assess comorbidity-adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (p < .001). Crude 28-day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46-0.98, p = .016). Between the early and late periods, the use of corticosteroids (>= 6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%], p < .001 and 50/571 [8.8%] vs. 213/402 [52.2%], p < .001, respectively), and the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%], p < .001 and 73/571 [12.8%] vs. 5/402 [1.2%], p < .001, respectively). Mortality among SOTR hospitalized for COVID-19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study.

引用

页码：279 / 288

页数：10

共 28 条

[1] Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series [J].

Argenziano, Michael G. ;

Bruce, Samuel L. ;

Slater, Cody L. ;

Tiao, Jonathan R. ;

Baldwin, Matthew R. ;

Barr, R. Graham ;

Chang, Bernard P. ;

Chau, Katherine H. ;

Choi, Justin J. ;

Gavin, Nicholas ;

Goyal, Parag ;

Mills, Angela M. ;

Patel, Ashmi A. ;

Romney, Marie-Laure S. ;

Safford, Monika M. ;

Schluger, Neil W. ;

Sengupta, Soumitra ;

Sobieszczyk, Magdalena E. ;

Zucker, Jason E. ;

Asadourian, Paul A. ;

Bell, Fletcher M. ;

Boyd, Rebekah ;

Cohen, Matthew F. ;

Colquhoun, MacAlistair I. ;

Colville, Lucy A. ;

de Jonge, Joseph H. ;

Dershowitz, Lyle B. ;

Dey, Shirin A. ;

Eiseman, Katherine A. ;

Girvin, Zachary P. ;

Goni, Daniella T. ;

Harb, Amro A. ;

Herzik, Nicholas ;

Householder, Sarah ;

Karaaslan, Lara E. ;

Lee, Heather ;

Lieberman, Evan ;

Ling, Andrew ;

Lu, Ree ;

Shou, Arthur Y. ;

Sisti, Alexander C. ;

Snow, Zachary E. ;

Sperring, Colin P. ;

Xiong, Yuqing ;

Zhou, Henry W. ;

Natarajan, Karthik ;

Hripcsak, George ;

Chen, Ruijun .

BMJ-BRITISH MEDICAL JOURNAL, 2020, 369

[2] Chest X-ray for predicting mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department [J].

Balbi, Maurizio ;

Caroli, Anna ;

Corsi, Andrea ;

Milanese, Gianluca ;

Surace, Alessandra ;

Di Marco, Fabiano ;

Novelli, Luca ;

Silva, Mario ;

Lorini, Ferdinando Luca ;

Duca, Andrea ;

Cosentini, Roberto ;

Sverzellati, Nicola ;

Bonaffini, Pietro Andrea ;

Sironi, Sandro .

EUROPEAN RADIOLOGY, 2021, 31 (04) :1999-2012

[3] Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19 (April 2020) [J].

Bhimraj, Adarsh ;

Morgan, Rebecca L. ;

Shumaker, Amy Hirsch ;

Lavergne, Valery ;

Baden, Lindsey ;

Cheng, Vincent Chi-Chung ;

Edwards, Kathryn M. ;

Gandhi, Rajesh ;

Muller, William J. ;

O'Horo, John C. ;

Shoham, Shmuel ;

Murad, M. Hassan ;

Mustafa, Reem A. ;

Sultan, Shahnaz ;

Falck-Ytter, Yngve .

CLINICAL INFECTIOUS DISEASES, 2020, 78 (07) :e83-e102

[4] Decreasing Incidence of Acute Kidney Injury in Patients with COVID-19 Critical Illness in New York City [J].

Charytan, David M. ;

Parnia, Sam ;

Khatri, Minesh ;

Petrilli, Christopher M. ;

Jones, Simon ;

Benstein, Judith ;

Horwitz, Leora, I .

KIDNEY INTERNATIONAL REPORTS, 2021, 6 (04) :916-927

[5] Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy [J].

Ciceri, Fabio ;

Castagna, Antonella ;

Rovere-Querini, Patrizia ;

De Cobelli, Francesco ;

Ruggeri, Annalisa ;

Galli, Laura ;

Conte, Caterina ;

De Lorenzo, Rebecca ;

Poli, Andrea ;

Ambrosio, Alberto ;

Signorelli, Carlo ;

Bossi, Eleonora ;

Fazio, Maria ;

Tresoldi, Cristina ;

Colombo, Sergio ;

Monti, Giacomo ;

Fominskiy, Efgeny ;

Franchini, Stefano ;

Spessot, Marzia ;

Martinenghi, Carlo ;

Carlucci, Michele ;

Beretta, Luigi ;

Scandroglio, Anna Maria ;

Clementi, Massimo ;

Locatelli, Massimo ;

Tresoldi, Moreno ;

Scarpellini, Paolo ;

Martino, Gianvito ;

Bosi, Emanuele ;

Dagna, Lorenzo ;

Lazzarin, Adriano ;

Landoni, Giovanni ;

Zangrillo, Alberto .

CLINICAL IMMUNOLOGY, 2020, 217

[6] COVID-19 in transplant recipients: The Spanish experience [J].

Coll, Elisabeth ;

Fernandez-Ruiz, Mario ;

Sanchez-Alvarez, J. Emilio ;

Martinez-Fernandez, Jose R. ;

Crespo, Marta ;

Gayoso, Jorge ;

Bada-Bosch, Teresa ;

Oppenheimer, Federico ;

Moreso, Francesc ;

Lopez-Oliva, Maria O. ;

Melilli, Edoardo ;

Rodriguez-Ferrero, Marisa L. ;

Bravo, Carlos ;

Burgos, Elena ;

Facundo, Carme ;

Lorenzo, Inmaculada ;

Yanez, Inigo ;

Galeano, Cristina ;

Roca, Ana ;

Cabello, Mercedes ;

Gomez-Bueno, Manuel ;

Garcia-Cosio, Ma Dolores ;

Graus, Javier ;

Llado, Laura ;

de Pablo, Alicia ;

Loinaz, Carmelo ;

Aguado, Beatriz ;

Hernandez, Domingo ;

Dominguez-Gil, Beatriz .

AMERICAN JOURNAL OF TRANSPLANTATION, 2021, 21 (05) :1825-1837

[7] Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020 [J].

Dennis, John M. ;

McGovern, Andrew P. ;

Vollmer, Sebastian J. ;

Mateen, Bilal A. .

CRITICAL CARE MEDICINE, 2021, 49 (02) :209-214

[8] Mortality Among US Patients Hospitalized With SARS-CoV-2 Infection in 2020 [J].

Finelli, Lyn ;

Gupta, Vikas ;

Petigara, Tanaz ;

Yu, Kalvin ;

Bauer, Karri A. ;

Puzniak, Laura A. .

JAMA NETWORK OPEN, 2021, 4 (04)

[9] Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals [J].

Flanagin, Annette ;

Frey, Tracy ;

Christiansen, Stacy L. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 326 (07) :621-627

[10] Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support [J].

Harris, Paul A. ;

Taylor, Robert ;

Thielke, Robert ;

Payne, Jonathon ;

Gonzalez, Nathaniel ;

Conde, Jose G. .

JOURNAL OF BIOMEDICAL INFORMATICS, 2009, 42 (02) :377-381

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