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

[21]

Petrilli CM, 2020, BMJ-BRIT MED J, V369, DOI [10.1136/bmj.m1966, 10.12890/2020_001747]

[22] COVID-19 mortality among kidney transplant candidates is strongly associated with social determinants of health [J].

Schold, Jesse D. ;

King, Kristen L. ;

Husain, S. Ali ;

Poggio, Emilio D. ;

Buccini, Laura D. ;

Mohan, Sumit .

AMERICAN JOURNAL OF TRANSPLANTATION, 2021, 21 (07) :2563-2572

[23] Racial and Neighborhood-Level Disparities in COVID-19 Incidence among Patients on Hemodialysis in New York City [J].

Tummalapalli, Sri Lekha ;

Silberzweig, Jeffrey ;

Cukor, Daniel ;

Lin, Jonathan T. ;

Barbar, Tarek ;

Liu, Yao ;

Kim, Kwan ;

Parker, Thomas S. ;

Levine, Daniel M. ;

Ibrahim, Said A. .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2021, 32 (08) :2048-2056

[24]

Wilfong EM., 2021, J EMERG CRIT CARE ME, V5, P7

[25] Substantial underestimation of SARS-CoV-2 infection in the United States [J].

Wu, Sean L. ;

Mertens, Andrew N. ;

Crider, Yoshika S. ;

Nguyen, Anna ;

Pokpongkiat, Nolan N. ;

Djajadi, Stephanie ;

Seth, Anmol ;

Hsiang, Michelle S. ;

Colford, John M., Jr. ;

Reingold, Art ;

Arnold, Benjamin F. ;

Hubbard, Alan ;

Benjamin-Chung, Jade .

NATURE COMMUNICATIONS, 2020, 11 (01)

[26] Association of Race With Mortality Among Patients Hospitalized With Coronavirus Disease 2019 (COVID-19) at 92 US Hospitals [J].

Yehia, Baligh R. ;

Winegar, Angela ;

Fogel, Richard ;

Fakih, Mohamad ;

Ottenbacher, Allison ;

Jesser, Christine ;

Bufalino, Angelo ;

Huang, Ren-Huai ;

Cacchione, Joseph .

JAMA NETWORK OPEN, 2020, 3 (08)

[27] Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [J].

Zhou, Fei ;

Yu, Ting ;

Du, Ronghui ;

Fan, Guohui ;

Liu, Ying ;

Liu, Zhibo ;

Xiang, Jie ;

Wang, Yeming ;

Song, Bin ;

Gu, Xiaoying ;

Guan, Lulu ;

Wei, Yuan ;

Li, Hui ;

Wu, Xudong ;

Xu, Jiuyang ;

Tu, Shengjin ;

Zhang, Yi ;

Chen, Hua ;

Cao, Bin .

LANCET, 2020, 395 (10229) :1054-1062

[28] Lymphopenia in critically ill COVID-19 patients: A predictor factor of severity and mortality [J].

Ziadi, Amra ;

Hachimi, Abdelhamid ;

Admou, Brahim ;

Hazime, Raja ;

Brahim, Imane ;

Douirek, Fouzia ;

Zarrouki, Youssef ;

El Adib, Ahmed R. ;

Younous, Said ;

Samkaoui, Abdenasser M. .

INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, 2021, 43 (01) :E38-E40

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