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Article Dans Une Revue American Journal of Transplantation Année : 2021

Is COVID‐19 infection more severe in kidney transplant recipients?

1 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
2 IRM - Immuno-Rhumatologie Moléculaire
3 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
4 CHU Tenon [AP-HP]
5 IMRB - Institut Mondor de Recherche Biomédicale
6 CHU Henri Mondor [Créteil]
7 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
8 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 UT - Université de Tours
11 Hôpital Edouard Herriot [CHU - HCL]
12 AMU - Aix Marseille Université
13 Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy
14 Service de Néphrologie [CHRU Nancy]
15 CHU Amiens-Picardie
16 CHU Montpellier
17 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
18 Hôpital universitaire Robert Debré [Reims]
19 URRIS UR2CA - Unité de Recherche Clinique de la Côte d’Azur
20 CHU - Hôpital Pasteur [Nice]
21 UNIROUEN - Université de Rouen Normandie
22 UB - Université de Bourgogne
23 UFC - Université de Franche-Comté
24 CHU Nantes - Centre Hospitalier Universitaire de Nantes
25 UP - Université de Poitiers = University of Poitiers
26 ImmunoConcept - Immunology from Concept and Experiments to Translation
27 CHU de Bordeaux Pellegrin [Bordeaux]
28 CIC - Centre d'Investigation Clinique [Rennes]
29 Irset - Institut de recherche en santé, environnement et travail
30 UA - Université d'Angers
31 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
32 MEPHI - Microbes évolution phylogénie et infections
33 LBAI - Lymphocytes B, Autoimmunité et Immunothérapies
34 CHU - BREST - Nephrologie - CHRU Brest - Service de Nephrologie
35 LabEX IGO Immunothérapie Grand Ouest
36 Université de Lille
Nathalie Chavarot
Philippe Gatault
Olivier Thaunat
Dominique Bertrand
Christiane Mousson
Gilles Blancho
Dany Anglicheau
Marc Hazzan

Résumé

There are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients
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Dates et versions

hal-03371189 , version 1 (18-10-2021)

Identifiants

Citer

Sophie Caillard, Nathalie Chavarot, Hélène Francois, Marie Matignon, Clarisse Greze, et al.. Is COVID‐19 infection more severe in kidney transplant recipients?. American Journal of Transplantation, 2021, 21 (3), pp.1295-1303. ⟨10.1111/ajt.16424⟩. ⟨hal-03371189⟩
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