Artículos de revistas
Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study
Fecha
2022-02-01Registro en:
Transplant International, v. 36.
1432-2277
0934-0874
10.3389/ti.2022.10205
2-s2.0-85124897556
Autor
Universidade Federal do Ceará
Hospital Universitário Walter Cantídio
Hospital Geral de Fortaleza
Hospital do Rim
Universidade Federal de São Paulo (UNIFESP)
Hospital Israelita Albert Einstein
Universidade Estadual Paulista (UNESP)
Santa Casa de Misericórdia de Porto Alegre
Faculdade de Medicina de São José do Rio Preto (FAMERP)
Universidade Federal do Maranhão
Universidade Federal do Rio Grande do Sul
Hospital Universitário Onofre Lopes (HOUL)
Hospital Santa Isabel
Santa Casa de Misericórdia de Juiz de Fora
Hospital de Base do Distrito Federal
Hospital Municipal São José (HMSJ)
Hospital Beneficência Portuguesa de São Paulo (BP)
Universidade de São Paulo (USP)
Universidade de Brasília (UnB)
Hospital São Francisco na Providência de Deus
Institución
Resumen
Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1: <72 days; Q2: 72–104 days; Q3: 105–140 days; Q4: >140 days after the index case). The 28-day fatality decreased from 29.5% (Q1) to 18.8% (Q4) (pfor-trend = 0.004). In multivariable analysis, patients diagnosed in Q4 showed a 35% reduced risk of death. The trend of reducing fatality was associated with a lower number of comorbidities (20.7–10.6%, pfor-trend = 0.002), younger age (55–53 years, pfor-trend = 0.062), and better baseline renal function (43.6–47.7 ml/min/1.73 m2, pfor-trend = 0.060), and were confirmed by multivariable analysis. The proportion of patients presenting dyspnea (pfor-trend = 0.001) and hypoxemia (pfor-trend < 0.001) at diagnosis, and requiring intensive care was also found reduced (pfor-trend = 0.038). Despite possible confounding variables and time-dependent sampling differences, we conclude that COVID-19-associated fatality decreased over time. Differences in demographics, clinical presentation, and treatment options might be involved.