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实体器官移植受者中的 COVID-19:与普通人群相比,生存率无差异。

COVID-19 in solid organ transplant recipients: No difference in survival compared to general population.

机构信息

Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola Malpighi, University of Bologna, Bologna, Italy.

Department of Experimental, Diagnostic and Specialty Medicine (DIMES)-Nephrology, Dialysis and Renal Transplant Unit, Policlinico Sant' Orsola Malpighi, University of Bologna, Bologna, Italy.

出版信息

Transpl Infect Dis. 2021 Feb;23(1):e13421. doi: 10.1111/tid.13421. Epub 2020 Aug 2.

Abstract

Coronavirus disease 2019 (COVID-19) may be associated with worse outcome in solid organ transplant (SOT) recipients. We performed a prospective cohort study of hospitalized patients with confirmed diagnosis of COVID-19, from March 15 to April 30, 2020, at two tertiary hospitals in Emilia-Romagna Region. SOT recipients were compared with non-SOT patients. Primary endpoint was all-cause 30-day mortality. Relationship between SOT status and mortality was investigated by univariable and multivariable Cox regression analysis. Patients were assessed from COVID-19 diagnosis to death or 30-day whichever occurred first. Study cohort consisted of 885 patients, of them 24 SOT recipients (n = 22, kidney, n = 2 liver). SOT recipients were younger, had lower BMI, but higher Charlson Index. At admission they presented less frequently with fever and respiratory failure. No difference in 30-day mortality between the two groups (19% vs 22.1%) was found; however, there was a trend toward higher rate of respiratory failure (50% vs 33.1%, P = .07) in SOT recipients. Superinfections were more represented in SOT recipients, (50% vs 15.5%, P < .001). At multivariate analysis adjusted for main covariates, there was no association between SOT and 30-day mortality HR 1.15 (95% CI 0.39-3.35) P = .79. Our data suggest that mortality among COVID-19 SOT recipients is similar to general population.

摘要

新型冠状病毒病 2019(COVID-19)可能与实体器官移植(SOT)受者的预后较差有关。我们对 2020 年 3 月 15 日至 4 月 30 日在艾米利亚-罗马涅地区的两家三级医院住院的确诊 COVID-19 患者进行了前瞻性队列研究。SOT 受者与非 SOT 患者进行了比较。主要终点是全因 30 天死亡率。通过单变量和多变量 Cox 回归分析研究 SOT 状态与死亡率之间的关系。从 COVID-19 诊断到死亡或 30 天(以先发生者为准)对患者进行评估。研究队列包括 885 例患者,其中 24 例 SOT 受者(n=22,肾脏,n=2 肝脏)。SOT 受者更年轻,BMI 较低,但 Charlson 指数较高。入院时,他们较少出现发热和呼吸衰竭。两组 30 天死亡率无差异(19%对 22.1%);然而,SOT 受者呼吸衰竭的发生率较高(50%对 33.1%,P=0.07)。SOT 受者中更常见合并感染(50%对 15.5%,P<0.001)。在调整主要协变量的多变量分析中,SOT 与 30 天死亡率之间无关联 HR 1.15(95%CI 0.39-3.35)P=0.79。我们的数据表明,COVID-19 SOT 受者的死亡率与一般人群相似。

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