A Report of 85 Cases of COVID-19 and Abdominal Transplantation From a Single Center: What Are the Associated Factors With Death Among Organ Transplantation Patients
A Report of 85 Cases of COVID-19 and Abdominal Transplantation From a Single Center: What Are the Associated Factors With Death Among Organ Transplantation Patients
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DOI：
10.1097/tp.0000000000003470
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发表时间：
2021-01-01
期刊：
影响因子：
6.2
通讯作者：
Nikeghbalian, Saman
中科院分区：
文献类型：
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作者：
Ali Malekhosseini, Seyed;Nikoupour, Hamed;Nikeghbalian, Saman
背景：在这项研究中，我们报告了器官移植受者中新冠肺炎的流行病学情况，并评估了与死亡相关的因素。方法：我们筛查了我们新冠肺炎中心接受器官移植的6969名患者。结果：我们发现85例患者获得了新冠肺炎，其中肝脏66例，肾脏16例，肾胰腺2例，肝肾联合移植1例。最常见的症状包括发热(48.2%)、咳嗽(41.2%)、肌痛(41.2%)和乏力(40%)。33%的患者出现呼吸困难。总体而言，三分之一的患者入院时血氧饱和度低于90%。患者住院天数中位数为9(5，13.7)天，重症监护病房住院率为33.9%。总体而言，17名患者(20%)死亡，其中31.3%的患者接受了肾移植，18.2%的患者接受了肝移植。本组4例儿科患者全部死亡。在我们对成人进行的单因素分析中，死亡的患者白细胞减少的发生率(38.4%比13.2%；P=0.04)、低白蛋白水平(53.8%比10.2%；P=0.001)以及移植到新冠肺炎的间隔时间短(P=0.02)。在我们的最小绝对收缩和选择算子回归模型中，低白蛋白水平(OR，4.48；95%可信区间，1.16-17.27)与更高的死亡风险相关。结论：这是关于腹部移植和新冠肺炎的最大单中心报告。与普通人群相比，肝肾移植受者因新冠肺炎而死亡的风险更高。更具体地说，儿科患者和白蛋白水平低的人死于新冠肺炎的风险更高。
Background.In this study, we report the epidemiology of COVID-19 among recipients of organ transplantation and evaluate associated factors with death.Methods.We screened 6969 patients who had organ transplantations in our center for COVID-19. Specific data on presentation, clinical course, treatment, and prognosis were acquired.Results.We found 85 patients (66 liver, 16 kidney, 2 kidney-pancreas, and 1 liver-kidney recipient) who acquired COVID-19. Most common symptoms included fever (48.2%), cough (41.2%), myalgia (41.2%), and fatigue (40%). Dyspnea developed in 33% of patients. Overall, one-third of patients had an oxygen saturation of below 90% on admission. Patients were hospitalized for a median (interquartile range) of 9 (5, 13.7) days and had a 33.9% intensive care unit admission rate. Overall, 17 patients (20%) died, which included 31.3% of patients with kidney transplantations and 18.2% of patients with liver transplantations. All 4 pediatric patients in our series died. In our univariate analysis among adults, rates of leukopenia (38.4% versus 13.2%; P = 0.04), low albumin levels (53.8% versus 10.2%; P = 0.001), and shorter duration between transplantation and COVID-19 (P = 0.02), were higher among patients who died. In our least absolute shrinkage and selection operator regression model, low albumin levels (OR, 4.48; 95% confidence interval, 1.16-17.27) were associated with higher risk of death.Conclusions.This is the largest single-center report on abdominal transplantations and COVID-19. Liver and kidney transplant recipients have an increased risk of mortality compared with the general population due to COVID-19. More specifically, pediatric patients and those with low albumin levels are at higher risks of death due COVID-19.