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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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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. |
format | Online Article Text |
id | pubmed-7644242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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