Details

Autor(en) / Beteiligte

• Hazzan, Marc
• Kamar, Nassim
• Francois, Hélène
• Matignon, Marie
• Greze, Clarisse
• Gatault, Philippe
• Frimat, Luc
• Westeel, Pierre F.
• Goutaudier, Valentin
• Snanoudj, Renaud
• Colosio, Charlotte
• Sicard, Antoine
• Bertrand, Dominique
• Mousson, Christiane
• Bamoulid, Jamal
• Thierry, Antoine
• Anglicheau, Dany
• Couzi, Lionel
• Chemouny, Jonathan M.
• Duveau, Agnes
• Moal, Valerie
• Le Meur, Yannick
• Blancho, Gilles
• Tourret, Jérôme
• Malvezzi, Paolo
• Mariat, Christophe
• Rerolle, Jean-Philippe
• Bouvier, Nicolas
• Caillard, Sophie
• Thaunat, Olivier

Titel

Absence of mortality differences between the 1st and 2nd covid waves in kidney transplant recipients

Ist Teil von

• Kidney international reports, 2022-09

Ort / Verlag

International Society of Nephrology. Published by Elsevier Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• SARS-CoV-2 pandemic evolved in two consecutive waves over 2020. Improvements in the management of COVID-19 led to a reduction of mortality rates in hospitalized patients during the second wave. Whether this progress also benefited to kidney transplant recipients (KTR), a population particularly vulnerable to severe COVID-19, remained unclear. In France, 957 KTR were hospitalized for COVID-19 in 2020 and their data were prospectively collected in the French SOT COVID registry. The presentation, management, and outcomes of the 359 KTR diagnosed during the 1 st wave were compared to those of the 598 of the 2 nd wave. Baseline comorbidities were similar between KTR of the 2 waves. Maintenance immunosuppression was reduced in most patients but withdrawal of antimetabolite (73.7% vs 58.4%, p<0.001) or CNI (32.1% vs 16.6%, p<0.001) was less frequent during the 2 nd wave. Hydroxychloroquine and azithromycin that were commonly used during the 1 st wave (21.7% and 30.9%, respectively) were almost abandoned during the 2 nd . In contrast, the use of high dose corticosteroids doubled (19.5% vs. 41.6%, p<0.001). Despite these changing trends in COVID-19 management, 60-day mortality was not statistically different between the 2 waves (25.3% vs. 23.9%; Log Rank, p=0.48) and COVID-19 hospitalization period was not associated with death due to COVID in multivariate analysis (HR 0.89, 95% CI 0.67 – 1.17, p = 0.4). We conclude that changing of therapeutic trends during 2020 did not reduce COVID-19 related mortality in KTR. Our data indirectly support the importance of vaccination and monoclonal neutralizing anti-SARS-CoV-2 antibodies to protect KTR from severe COVID-19.