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Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era

INTRODUCTION: There are limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of coronavirus disease 2019 (COVID-19) remains. In this study we delineate the differential risks involved using serologic methods to help define exposure rate...

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Autores principales: Clarke, Candice, Lucisano, Gaetano, Prendecki, Maria, Gleeson, Sarah, Martin, Paul, Ali, Mahrukh, McAdoo, Stephen P., Lightstone, Liz, Ashby, Damien, Charif, Rawya, Griffith, Megan, McLean, Adam, Dor, Frank, Willicombe, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644242/
https://www.ncbi.nlm.nih.gov/pubmed/33173838
http://dx.doi.org/10.1016/j.ekir.2020.10.032
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author Clarke, Candice
Lucisano, Gaetano
Prendecki, Maria
Gleeson, Sarah
Martin, Paul
Ali, Mahrukh
McAdoo, Stephen P.
Lightstone, Liz
Ashby, Damien
Charif, Rawya
Griffith, Megan
McLean, Adam
Dor, Frank
Willicombe, Michelle
author_facet Clarke, Candice
Lucisano, Gaetano
Prendecki, Maria
Gleeson, Sarah
Martin, Paul
Ali, Mahrukh
McAdoo, Stephen P.
Lightstone, Liz
Ashby, Damien
Charif, Rawya
Griffith, Megan
McLean, Adam
Dor, Frank
Willicombe, Michelle
author_sort Clarke, Candice
collection PubMed
description INTRODUCTION: There are limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of coronavirus disease 2019 (COVID-19) remains. In this study we delineate the differential risks involved using serologic methods to help define exposure rates. METHODS: From a cohort of 1433 patients with end-stage kidney disease (ESKD), we analyzed COVID-19 infection rates and outcomes in 299 waitlist patients compared with 237 transplant recipients within their first year post-transplant. Patients were followed over a 68-day period from the time our transplant program closed due to COVID-19. RESULTS: The overall mortality rates in waitlist and transplant populations were equivalent (P = 0.69). However, COVID-19 infection was more commonly diagnosed in the waitlist patients (P = 0.001), who were more likely to be tested by reverse transcriptase polymerase chain reaction (P = 0.0004). Once infection was confirmed, mortality risk was higher in the transplant patients (P = 0.015). The seroprevalence in dialysis and transplant patients with undetected infection was 18.3% and 4.6%, respectively (P = 0.0001). After adjusting for potential screening bias, the relative risk of death after a diagnosis of COVID-19 remained higher in transplant recipients (hazard ratio = 3.36 [95% confidence interval = 1.19–9.50], P = 0.022). CONCLUSIONS: Although COVID-19 infection was more common in the waitlist patients, a higher COVID-19‒associated mortality rate was seen in the transplant recipients, resulting in comparable overall mortality rates.
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spelling pubmed-76442422020-11-06 Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era Clarke, Candice Lucisano, Gaetano Prendecki, Maria Gleeson, Sarah Martin, Paul Ali, Mahrukh McAdoo, Stephen P. Lightstone, Liz Ashby, Damien Charif, Rawya Griffith, Megan McLean, Adam Dor, Frank Willicombe, Michelle Kidney Int Rep Clinical Research INTRODUCTION: There are limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of coronavirus disease 2019 (COVID-19) remains. In this study we delineate the differential risks involved using serologic methods to help define exposure rates. METHODS: From a cohort of 1433 patients with end-stage kidney disease (ESKD), we analyzed COVID-19 infection rates and outcomes in 299 waitlist patients compared with 237 transplant recipients within their first year post-transplant. Patients were followed over a 68-day period from the time our transplant program closed due to COVID-19. RESULTS: The overall mortality rates in waitlist and transplant populations were equivalent (P = 0.69). However, COVID-19 infection was more commonly diagnosed in the waitlist patients (P = 0.001), who were more likely to be tested by reverse transcriptase polymerase chain reaction (P = 0.0004). Once infection was confirmed, mortality risk was higher in the transplant patients (P = 0.015). The seroprevalence in dialysis and transplant patients with undetected infection was 18.3% and 4.6%, respectively (P = 0.0001). After adjusting for potential screening bias, the relative risk of death after a diagnosis of COVID-19 remained higher in transplant recipients (hazard ratio = 3.36 [95% confidence interval = 1.19–9.50], P = 0.022). CONCLUSIONS: Although COVID-19 infection was more common in the waitlist patients, a higher COVID-19‒associated mortality rate was seen in the transplant recipients, resulting in comparable overall mortality rates. Elsevier 2020-11-05 /pmc/articles/PMC7644242/ /pubmed/33173838 http://dx.doi.org/10.1016/j.ekir.2020.10.032 Text en © 2020 Published by Elsevier, Inc., on behalf of the International Society of Nephrology. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Clarke, Candice
Lucisano, Gaetano
Prendecki, Maria
Gleeson, Sarah
Martin, Paul
Ali, Mahrukh
McAdoo, Stephen P.
Lightstone, Liz
Ashby, Damien
Charif, Rawya
Griffith, Megan
McLean, Adam
Dor, Frank
Willicombe, Michelle
Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title_full Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title_fullStr Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title_full_unstemmed Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title_short Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era
title_sort informing the risk of kidney transplantation versus remaining on the waitlist in the coronavirus disease 2019 era
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644242/
https://www.ncbi.nlm.nih.gov/pubmed/33173838
http://dx.doi.org/10.1016/j.ekir.2020.10.032
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