Clinical characteristics and risk factors for severe COVID-19 in hospitalized kidney transplant recipients: A multicentric cohort study.
Alexandre FavàDavid CucchiariNuria Montero PérezNestor ToapantaFrancisco J CentellasAnna Vila-SantandreuAna ColomaMaria MeneghiniAnna ManonellesJoana SellarésIrina TorresRosana GelpiInmaculada LorenzoPedro Ventura-AguiarFrederic CofanJose V TorregrosaManel PerellóCarme FacundoDaniel SeronFederico OppenheimerOriol BestardJosep M CruzadoFrancesc J MoresoEdoardo MelilliPublished in: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2020)
Kidney transplant recipients might be at higher risk for severe coronavirus disease 2019 (COVID-19). However, risk factors for relevant outcomes remain uncertain in this population. This is a multicentric kidney transplant cohort including 104 hospitalized patients between March 4 and April 17, 2020. Risk factors for death and acute respiratory distress syndrome (ARDS) were investigated, and clinical and laboratory data were analyzed. The mean age was 60 years. Forty-seven patients (54.8%) developed ARDS. Obesity was associated to ARDS development (OR 2.63; P = .04). Significant age differences were not found among patients developing and not developing ARDS (61.3 vs 57.8 years, P = .16). Seventy-six (73%) patients were discharged, and 28 (27%) died. Death was more common among the elderly (55 and 70.8 years, P < .001) and those with preexisting pulmonary disease (OR 2.89, P = .009). At admission, higher baseline lactate dehydrogenase (257 vs 358 IU/mL, P = .001) or ARDS conferred higher risk of death (HR 2.09, P = .044). In our cohort, ARDS was equally present among young and old kidney recipients. However, the elderly might be at higher risk of death, along with those showing higher baseline LDH at admission.
Keyphrases
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- coronavirus disease
- mechanical ventilation
- end stage renal disease
- ejection fraction
- sars cov
- emergency department
- chronic kidney disease
- newly diagnosed
- prognostic factors
- metabolic syndrome
- early onset
- pulmonary hypertension
- intensive care unit
- machine learning
- mass spectrometry
- skeletal muscle
- electronic health record
- data analysis