COVID-19 in solid organ transplant recipients: No difference in survival compared to general population
COVID-19 in solid organ transplant recipients: No difference in survival compared to general population
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DOI：
10.1111/tid.13421
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发表时间：
2020-08-02
影响因子：
2.6
通讯作者：
Giannella, Maddalena
中科院分区：
文献类型：
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作者：
Rinaldi, Matteo;Bartoletti, Michele;Giannella, Maddalena
2019年冠状病毒病（COVID-19）可能与实体器官移植（SOT）受者的预后恶化有关。我们于2020年3月15日至4月30日在埃米利亚-罗马涅大区的两家三级医院对确诊为COVID-19的住院患者进行了一项前瞻性队列研究。将SOT接受者与非SOT患者进行比较。主要终点为30天全因死亡率。采用单因素和多因素考克斯回归分析SOT状态与死亡率的关系。患者从COVID-19诊断到死亡或30天（以先发生者为准）进行评估。研究队列包括885例患者，其中24例SOT接受者（n = 22，肾脏，n = 2肝脏）。SOT接受者更年轻，BMI更低，但Charlson指数更高。入院时，他们很少出现发热和呼吸衰竭。两组之间的30天死亡率没有差异（19%对22.1%）;然而，SOT接受者的呼吸衰竭发生率有升高的趋势（50%对33.1%，P = 0.07）。重复感染在SOT受者中更常见（50%vs15.5%，P <0.001）。在调整主要协变量的多变量分析中，SOT与30天死亡率HR 1.15（95% CI 0.39-3.35）之间无相关性，P = 0.79。我们的数据表明，COVID-19 SOT接受者的死亡率与一般人群相似。
Coronavirus disease 2019 (COVID-19) may be associated with worse outcome in solid organ transplant (SOT) recipients. We performed a prospective cohort study of hospitalized patients with confirmed diagnosis of COVID-19, from March 15 to April 30, 2020, at two tertiary hospitals in Emilia-Romagna Region. SOT recipients were compared with non-SOT patients. Primary endpoint was all-cause 30-day mortality. Relationship between SOT status and mortality was investigated by univariable and multivariable Cox regression analysis. Patients were assessed from COVID-19 diagnosis to death or 30-day whichever occurred first. Study cohort consisted of 885 patients, of them 24 SOT recipients (n = 22, kidney, n = 2 liver). SOT recipients were younger, had lower BMI, but higher Charlson Index. At admission they presented less frequently with fever and respiratory failure. No difference in 30-day mortality between the two groups (19% vs 22.1%) was found; however, there was a trend toward higher rate of respiratory failure (50% vs 33.1%,P = .07) in SOT recipients. Superinfections were more represented in SOT recipients, (50% vs 15.5%,P < .001). At multivariate analysis adjusted for main covariates, there was no association between SOT and 30-day mortality HR 1.15 (95% CI 0.39-3.35)P = .79. Our data suggest that mortality among COVID-19 SOT recipients is similar to general population.