Wongtanasarasin Wachira, Phinyo Phichayut
Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States.
World J Transplant. 2022 Aug 18;12(8):250-258. doi: 10.5500/wjt.v12.i8.250.
Several studies have demonstrated that the coronavirus disease 2019 (COVID-19) has affected daily living and the healthcare system. No previous study has described the consequences of COVID-19 on emergency department (ED) visits and hospital admission among kidney transplant (KT) recipients.
To investigate the impact of the COVID-19 pandemic on ED visits and hospital admissions within 1 year in patients who underwent KT in Thailand.
We conducted a retrospective study at a university hospital in Thailand. We reviewed the hospital records of KT patients who visited the ED during the outbreak of COVID-19 (from January 2020 to December 2021). We used the previous 2 years as the control period in the analysis. We obtained baseline demographics and ED visit characteristics for each KT patient. The outcomes of interest were ED visits and ED visits leading to hospital admission within the 1 year following a KT. The rate of ED visits and ED visits leading to hospital admissions between the two periods were compared using the stratified Cox proportional hazards model.
A total of 263 patients were included in this study: 112 during the COVID-19 period and 151 during the control period. There were 34 and 41 ED visits after KT in the COVID-19 and control periods, respectively. The rate of first ED visit at 1 year was not significantly different in the COVID-19 period, compared with the control period [hazard ratio (HR) = 1.02, 95% confidence interval (CI): 0.54-1.92; = 0.96]. The hospital admission rate was similar between periods (HR = 0.92, 95%CI: 0.50-1.69; = 0.78).
ED visits and hospital admissions within the 1 year in KT recipients were not affected by the COVID-19 pandemic. Despite these findings, we believe that communication between post-KT patients and healthcare providers is essential to highlight the importance of prompt ED visits for acute health conditions, particularly in post-KT patients.
多项研究表明，2019冠状病毒病（COVID-19）对日常生活和医疗系统产生了影响。此前尚无研究描述COVID-19对肾移植（KT）受者急诊就诊和住院的影响。
调查COVID-19大流行对泰国接受KT的患者1年内急诊就诊和住院的影响。
我们在泰国一家大学医院进行了一项回顾性研究。我们回顾了COVID-19疫情期间（2020年1月至2021年12月）到急诊就诊的KT患者的医院记录。我们将前两年作为分析中的对照期。我们获取了每位KT患者的基线人口统计学和急诊就诊特征。感兴趣的结果是KT后1年内的急诊就诊以及导致住院的急诊就诊。使用分层Cox比例风险模型比较两个时期的急诊就诊率和导致住院的急诊就诊率。
本研究共纳入263例患者：COVID-19期间112例，对照期151例。COVID-19期和对照期KT后分别有34次和41次急诊就诊。与对照期相比，COVID-19期1年时首次急诊就诊率无显著差异[风险比（HR）=1.02，95%置信区间（CI）：0.54 - 1.92；P = 0.96]。两个时期的住院率相似（HR = 0.92，95%CI：0.50 - 1.69；P = 0.78）。
COVID-19大流行未影响KT受者1年内的急诊就诊和住院情况。尽管有这些发现，但我们认为KT后患者与医疗服务提供者之间的沟通对于强调急性健康状况下及时急诊就诊的重要性至关重要，尤其是在KT后患者中。
