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