Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York.
North Shore University Hospital, Northwell Health, Manhasset, New York.
Am J Transplant. 2021 Jul;21(7):2522-2531. doi: 10.1111/ajt.16460. Epub 2021 Jan 13.
We compared the outcome of COVID-19 in immunosuppressed solid organ transplant (SOT) patients to a transplant naïve population. In total, 10 356 adult hospital admissions for COVID-19 from March 1, 2020 to April 27, 2020 were analyzed. Data were collected on demographics, baseline clinical conditions, medications, immunosuppression, and COVID-19 course. Primary outcome was combined death or mechanical ventilation. We assessed the association between primary outcome and prognostic variables using bivariate and multivariate regression models. We also compared the primary endpoint in SOT patients to an age, gender, and comorbidity-matched control group. Bivariate analysis found transplant status, age, gender, race/ethnicity, body mass index, diabetes, hypertension, cardiovascular disease, COPD, and GFR <60 mL/min/1.73 m to be significant predictors of combined death or mechanical ventilation. After multivariate logistic regression analysis, SOT status had a trend toward significance (odds ratio [OR] 1.29; 95% CI 0.99-1.69, p = .06). Compared to an age, gender, and comorbidity-matched control group, SOT patients had a higher combined risk of death or mechanical ventilation (OR 1.34; 95% CI 1.03-1.74, p = .027).
我们比较了 COVID-19 免疫抑制实体器官移植(SOT)患者与移植未接受人群的结局。总共分析了 2020 年 3 月 1 日至 2020 年 4 月 27 日期间 10356 例成人因 COVID-19 住院的病例。收集了人口统计学、基线临床状况、药物、免疫抑制和 COVID-19 病程的数据。主要结局是联合死亡或机械通气。我们使用双变量和多变量回归模型评估主要结局与预后变量之间的关联。我们还将 SOT 患者的主要终点与年龄、性别和合并症匹配的对照组进行了比较。双变量分析发现,移植状态、年龄、性别、种族/族裔、体重指数、糖尿病、高血压、心血管疾病、COPD 和肾小球滤过率<60 mL/min/1.73 m 是联合死亡或机械通气的显著预测因素。多变量逻辑回归分析后,SOT 状态具有显著趋势(比值比 [OR] 1.29;95%CI 0.99-1.69,p=0.06)。与年龄、性别和合并症匹配的对照组相比,SOT 患者的死亡或机械通气联合风险更高(OR 1.34;95%CI 1.03-1.74,p=0.027)。