Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
Division of Abdominal Transplantation, Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
Clin Transplant. 2021 Aug;35(8):e14362. doi: 10.1111/ctr.14362. Epub 2021 May 28.
COVID-19 epidemiologic studies comparing immunosuppressed and immunocompetent patients may provide insight into the impact of immunosuppressants on outcomes.
In this retrospective cohort study, we assembled kidney or kidney-pancreas transplant recipients who underwent transplant from January 1, 2010, to June 30, 2020, and kidney or kidney-pancreas waitlisted patients who were ever on the waitlist from January 1, 2019, to June 30, 2020. We identified laboratory-confirmed COVID-19 until January 31, 2021, and tracked its outcomes by leveraging informatics infrastructure developed for an outcomes research network.
COVID-19 was identified in 62 of 887 kidney or kidney-pancreas transplant recipients and 20 of 434 kidney or kidney-pancreas waitlisted patients (7.0% vs. 4.6%, p = .092). Of these patients with COVID-19, hospitalization occurred in 48 of 62 transplant recipients and 8 of 20 waitlisted patients (77% vs. 40%, p = .002); intensive care unit admission occurred in 18 of 62 transplant recipients and 2 of 20 waitlisted patients (29% vs. 10%, p = .085); and 7 transplant recipients were mechanically ventilated and died, whereas no waitlisted patients were mechanically ventilated or died (11% vs. 0%, p = .116).
Our study provides single-center data and an informatics approach that can be used to inform the design of multicenter studies.
比较免疫抑制和免疫功能正常患者的 COVID-19 流行病学研究可能有助于了解免疫抑制剂对结局的影响。
在这项回顾性队列研究中，我们收集了 2010 年 1 月 1 日至 2020 年 6 月 30 日期间接受肾或肾胰移植的患者，以及 2019 年 1 月 1 日至 2020 年 6 月 30 日期间曾在等待名单上的肾或肾胰等待移植患者。我们确定了实验室确诊的 COVID-19，直到 2021 年 1 月 31 日，并利用为一个结果研究网络开发的信息学基础设施跟踪其结果。
在 887 例肾或肾胰移植受者和 434 例肾或肾胰等待移植患者中发现了 62 例 COVID-19（7.0% vs. 4.6%，p=0.092）。这些 COVID-19 患者中，48 例移植受者和 8 例等待移植患者住院（77% vs. 40%，p=0.002）；18 例移植受者和 2 例等待移植患者入住重症监护病房（29% vs. 10%，p=0.085）；7 例移植受者需要机械通气和死亡，而没有等待移植的患者需要机械通气或死亡（11% vs. 0%，p=0.116）。
我们的研究提供了单中心数据和一种信息学方法，可用于为多中心研究的设计提供信息。
