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Comparison of 30-day case-fatality rate between dialysis and transplant Covid-19 patients: a propensity score matched cohort study.
de Sandes-Freitas, Tainá Veras; de Andrade, Luís Gustavo Modelli; Moura, Lucio Roberto Requião; Cristelli, Marina Pontello; Medina-Pestana, José Osmar; Lugon, Jocemir Ronaldo; Sesso, Ricardo.
Afiliação
  • de Sandes-Freitas TV; Programa de Pós-Graduação Em Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Do Ceará, Fortaleza, CE, Brazil.
  • de Andrade LGM; Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil.
  • Moura LRR; Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • Cristelli MP; Departamento de Medicina Interna, Universidade Estadual Paulista-UNESP, Botucatu, SP, Brazil.
  • Medina-Pestana JO; Hospital Do Rim, Fundação Oswaldo Ramos, São Paulo, SP, Brazil. lucio.requiao@gmail.com.
  • Lugon JR; Departamento de Medicina, Disciplina de Nefrologia, Universidade Federal de São Paulo. Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil. lucio.requiao@gmail.com.
  • Sesso R; Unidade de Transplante Renal, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. lucio.requiao@gmail.com.
J Nephrol ; 35(1): 131-141, 2022 Jan.
Article em En | MEDLINE | ID: mdl-34677805
BACKGROUND 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Teste para COVID-19 / COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Teste para COVID-19 / COVID-19 Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália