Comparison of 30-day case-fatality rate between dialysis and transplant Covid-19 patients: a propensity score matched cohort study

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dc.contributor.authorde Sandes-Freitas, Tainá Veras
dc.contributor.authorde Andrade, Luís Gustavo Modelli [UNESP]
dc.contributor.authorMoura, Lucio Roberto Requião
dc.contributor.authorCristelli, Marina Pontello
dc.contributor.authorMedina-Pestana, José Osmar
dc.contributor.authorLugon, Jocemir Ronaldo
dc.contributor.authorSesso, Ricardo
dc.contributor.institutionUniversidade Federal Do Ceará
dc.contributor.institutionHospital Universitário Walter Cantídio
dc.contributor.institutionHospital Geral de Fortaleza
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionFundação Oswaldo Ramos
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionHospital Israelita Albert Einstein
dc.contributor.institutionUniversidade Federal Fluminense (UFF)
dc.date.accessioned2022-04-29T08:46:02Z
dc.date.available2022-04-29T08:46:02Z
dc.date.issued2022-01-01
dc.description.abstractBackground and objectives: Patients undergoing kidney replacement therapies (KRTs) have a poor prognosis after Covid-19 infection. Few studies have compared the outcomes of such patients in the different KRT modalities. This study aimed to analyze the 30-day Covid-19-associated case-fatality rate of dialysis and kidney transplant patients. Methods: Retrospective cohort study analyzing data from patients with confirmed Covid-19 between Mar/20 and Jan/21 included in two multicenter studies, the Brazilian Covid-19 Dialysis Study (Dialysis group, n = 703) and the Covid-19-KT Brazilian Study (Transplant group, n = 1907). To assess the risk factors for death, adjusted Cox hazards models were used. A sensitivity analysis was performed using a propensity score analysis to match the groups (n = 587 patients in each group). Results: A higher percentage of transplant patients required hospitalization (68 vs. 51%, p < 0.001), intensive care (37 vs. 30%, p = 0.023), and invasive mechanical ventilation (28 vs. 22%, p = 0.035). Multivariate analysis of the before-matching sample showed that subjects in the transplant group were at a lower death risk at baseline (HR 0.380.560.85). However, they showed higher risk over time (HR 1.031.061.09). Kaplan–Meier analysis after propensity score matching confirmed the inferior 30-day cumulative survival in the transplant recipients (83 vs. 78%, p = 0.0014). Conclusion: Both transplant and dialysis patients have high 30-day case-fatality rates after a Covid-19 diagnosis. Despite lower death risk at baseline, transplant patients have an increased death risk of 6% per day than dialysis patients. Graphical Abstract: [Figure not available: see fulltext.]en
dc.description.affiliationPrograma de Pós-Graduação Em Ciências Médicas Departamento de Medicina Clínica Faculdade de Medicina Universidade Federal Do Ceará, CE
dc.description.affiliationHospital Universitário Walter Cantídio, CE
dc.description.affiliationHospital Geral de Fortaleza, CE
dc.description.affiliationDepartamento de Medicina Interna Universidade Estadual Paulista-UNESP, SP
dc.description.affiliationHospital Do Rim Fundação Oswaldo Ramos, SP
dc.description.affiliationDepartamento de Medicina Disciplina de Nefrologia Universidade Federal de São Paulo. Rua Botucatu, 740, SP
dc.description.affiliationUnidade de Transplante Renal Hospital Israelita Albert Einstein, SP
dc.description.affiliationDepartamento de Medicina Divisão de Nefrologia Universidade Federal Fluminense, RJ
dc.description.affiliationUnespDepartamento de Medicina Interna Universidade Estadual Paulista-UNESP, SP
dc.format.extent131-141
dc.identifierhttp://dx.doi.org/10.1007/s40620-021-01172-1
dc.identifier.citationJournal of Nephrology, v. 35, n. 1, p. 131-141, 2022.
dc.identifier.doi10.1007/s40620-021-01172-1
dc.identifier.issn1724-6059
dc.identifier.issn1121-8428
dc.identifier.scopus2-s2.0-85117895231
dc.identifier.urihttp://hdl.handle.net/11449/231539
dc.language.isoeng
dc.relation.ispartofJournal of Nephrology
dc.sourceScopus
dc.subjectCOVID-19
dc.subjectKidney transplantation
dc.subjectPropensity score
dc.subjectRenal dialysis
dc.titleComparison of 30-day case-fatality rate between dialysis and transplant Covid-19 patients: a propensity score matched cohort studyen
dc.typeArtigo
unesp.author.orcid0000-0002-4435-0614[1]
unesp.author.orcid0000-0002-0230-0766[2]
unesp.author.orcid0000-0001-8751-9048[3]
unesp.author.orcid0000-0002-2813-0400[4]
unesp.author.orcid0000-0002-0750-7360[5]
unesp.author.orcid0000-0001-6791-3910[6]
unesp.author.orcid0000-0002-1062-0073[7]

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