COVID-19-related mortality in kidney transplant and haemodialysis patients: A comparative, prospective registry-based study

Goffin, E.; Candellier, A.; Vart, P.; Noordzij, M.; Arnol, M.; Covic, A.; Lentini, P.; Malik, S.; Reichert, L.J.; Sever, M.S.; Watschinger, B.; Jager, K.J.; Gansevoort, R.T.; Van Der Net, J.B.; Essig, M.; Du Buf-Vereijken, P.W.G.; Van Ginneken, B.; Vogt, L.; Van Jaarsveld, B.C.; Bemelman, F.J.; Klingenberg-Salahova, F.; Heenan-Vos, F.; Vervloet, M.G.; Nurmohamed, A.; Abramowicz, D.; Verhofstede, S.; Maoujoud, O.; Malfait, T.; Avitum, B.B.; Fialova, J.; Melilli, E.; Fava, A.; Cruzado, J.M.; Perez, N.M.; Lips, J.; Krepel, H.; Adilovic, H.; Hengst, M.; Rydzewski, A.; Gellert, R.; Oliveira, J.; Alferes, D.G.; Zakharova, E.V.; Ambuehl, P.M.; Walker, A.; Winzeler, R.; Lepeytre, F.; Rabate, C.; Rostoker, G.; Marques, S.; Azasevac, T.; Katicic, D.; Ten Dam, M.; Kruger, T.; Brzosko, S.; Zanen, A.L.; Logtenberg, S.J.J.; Fricke, L.; Slebe, J.J.P.; Kemlin, D.; Van De Wetering, J.; Reinders, M.E.J.; Eiselt, J.; Kielberger, L.; El-Wakil, H.S.; Verhoeven, M.A.M.; Canal, C.; Facundo, C.; Ramos, A.M.; Debska-Slizien, A.; Veldhuizen, N.M.H.; Tigka, E.; Konsta, M.A.P.; Panagoutsos, S.; Mallamaci, F.; Matceac, I.; Nistor, I.; Cordos, M.; Groeneveld, J.H.M.; Jousma, J.; Van Buren, M.; Elhafeez, S.A.; Diekmann, F.; Pereira, T.A.; Santos, A.C.S.; Arias-Cabrales, C.; Crespo, M.; Llinas-Mallol, L.; Buxeda, A.; Tarrega, C.B.; Redondo-Pachon, D.; Jimenez, M.D.A.; Hofstra, J.M.; Franco, A.; Arroyo, D.; Rodriguez-Ferrero, M.L.; Manzanos, S.B.; Barrios, R.H.S.; Avila, G.; Laranjinha, I.; Mateus, C.; Lemahieu, W.; Dirim, A.B.; Demir, E.; A afak, S.; Turkmen, A.; Hollander, D.A.M.J.; Buttner, S.; De Vries, A.P.J.; Meziyerh, S.; Van Der Helm, D.; Mallat, M.; Bouwsma, H.; Sridharan, S.; Petruliene, K.; Maloney, S.-.; Verberk, I.; Van Der Sande, F.M.; Christiaans, M.H.L.; Hemmelder, M.; Kumar, M.N.; Di Luca, M.; Tuglular, S.Z.; Kramer, A.; Beerenhout, C.; Luik, P.T.; Kerschbaum, J.; Tiefenthaler, M.; Adema, A.Y.; Stepanov, V.A.; Zulkarnaev, A.B.; Turkmen, K.; Fliedner, A.; Asberg, A.; Mjoen, G.; Miyasato, H.; De Fijter, C.W.H.; Mongera, N.; Pini, S.; De Biase, C.; Duivenvoorden, R.; Hilbrands, L.; Kerckhoffs, A.; Maas, R.; Lebedeva, O.; Lopez, V.; Verhave, J.; Titov, D.; Parshina, E.V.; Zanoli, L.; Marcantoni, C.; Van Gils-Verrij, L.E.A.; Harty, J.C.; Meurs, M.; Myslak, M.; Battaglia, Y.; Den Deurwaarder, E.; Stendahl, M.; Rahimzadeh, H.; Schouten, M.; Rychlik, I.; Cabezas-Reina, C.J.; Roca, A.M.; Nauta, F.; Kanaan, N.; Labriola, L.; Devresse, A.; Diaz-Mareque, A.; Coca, A.; Meijers, B.K.I.; Naesens, M.; Kuypers, D.; Desschans, B.; Tonnelier, A.; Wissing, K.M.; De Arriba, G.; Dedinska, I.; Pessolano, G.; Gandolfini, I.; Maggiore, U.; Papachristou, E.; Franssen, C.F.M.; Berger, S.P.; Meijer, E.; Ozyilmaz, A.; Sanders, J.S.F.; Ponikvar, J.B.; Pernat, A.M.; Kovac, D.; Ekart, R.; Abrahams, A.C.; Molenaar, F.M.; Van Zuilen, A.D.; Meijvis, S.C.A.; Dolmans, H.; Tantisattamos, E.; Esposito, P.; Krzesinski, J.-.; Barahira, J.D.; Gallieni, M.; Sabiu, G.; Martin-Moreno, P.L.; Guglielmetti, G.; Guzzo, G.; Toapanta, N.; Luik, A.J.; Van Kuijk, W.H.M.; Stikkelbroeck, L.W.H.; Hermans, M.M.H.; Rimsevicius, L.; Righetti, M.; Islam, M.; Braak, N.H.-.

doi:10.1093/ndt/gfab200

Background: Coronavirus disease 2019 (COVID-19) has exposed haemodialysis (HD) patients and kidney transplant (KT) recipients to an unprecedented life-threatening infectious disease, raising concerns about kidney replacement therapy (KRT) strategy during the pandemic. This study investigated the association of the type of KRT with COVID-19 severity, adjusting for differences in individual characteristics. Methods: Data on KT recipients and HD patients diagnosed with COVID-19 between 1 February 2020 and 1 December 2020 were retrieved from the European Renal Association COVID-19 Database. Cox regression models adjusted for age, sex, frailty and comorbidities were used to estimate hazard ratios (HRs) for 28-day mortality risk in all patients and in the subsets that were tested because of symptoms. Results: A total of 1670 patients (496 functional KT and 1174 HD) were included; 16.9% of KT and 23.9% of HD patients died within 28 days of presentation. The unadjusted 28-day mortality risk was 33% lower in KT recipients compared with HD patients {HR 0.67 [95% confidence interval (CI) 0.52-0.85]}. In a fully adjusted model, the risk was 78% higher in KT recipients [HR 1.78 (95% CI 1.22-2.61)] compared with HD patients. This association was similar in patients tested because of symptoms [fully adjusted model HR 2.00 (95% CI 1.31-3.06)]. This risk was dramatically increased during the first post-transplant year. Results were similar for other endpoints (e.g. hospitalization, intensive care unit admission and mortality >28 days) and across subgroups. Conclusions: KT recipients had a greater risk of a more severe course of COVID-19 compared with HD patients, therefore they require specific infection mitigation strategies.

COVID-19-related mortality in kidney transplant and haemodialysis patients: A comparative, prospective registry-based study / E. Goffin, A. Candellier, P. Vart, M. Noordzij, M. Arnol, A. Covic, P. Lentini, S. Malik, L.J. Reichert, M.S. Sever, B. Watschinger, K.J. Jager, R.T. Gansevoort, J.B. Van Der Net, M. Essig, P.W.G. Du Buf-Vereijken, B. Van Ginneken, L. Vogt, B.C. Van Jaarsveld, F.J. Bemelman, F. Klingenberg-Salahova, F. Heenan-Vos, M.G. Vervloet, A. Nurmohamed, D. Abramowicz, S. Verhofstede, O. Maoujoud, T. Malfait, B.B. Avitum, J. Fialova, E. Melilli, A. Fava, J.M. Cruzado, N.M. Perez, J. Lips, H. Krepel, H. Adilovic, M. Hengst, A. Rydzewski, R. Gellert, J. Oliveira, D.G. Alferes, E.V. Zakharova, P.M. Ambuehl, A. Walker, R. Winzeler, F. Lepeytre, C. Rabate, G. Rostoker, S. Marques, T. Azasevac, D. Katicic, M. Ten Dam, T. Kruger, S. Brzosko, A.L. Zanen, S.J.J. Logtenberg, L. Fricke, J.J.P. Slebe, D. Kemlin, J. Van De Wetering, M.E.J. Reinders, J. Eiselt, L. Kielberger, H.S. El-Wakil, M.A.M. Verhoeven, C. Canal, C. Facundo, A.M. Ramos, A. Debska-Slizien, N.M.H. Veldhuizen, E. Tigka, M.A.P. Konsta, S. Panagoutsos, F. Mallamaci, I. Matceac, I. Nistor, M. Cordos, J.H.M. Groeneveld, J. Jousma, M. Van Buren, S.A. Elhafeez, F. Diekmann, T.A. Pereira, A.C.S. Santos, C. Arias-Cabrales, M. Crespo, L. Llinas-Mallol, A. Buxeda, C.B. Tarrega, D. Redondo-Pachon, M.D.A. Jimenez, J.M. Hofstra, A. Franco, D. Arroyo, M.L. Rodriguez-Ferrero, S.B. Manzanos, R.H.S. Barrios, G. Avila, I. Laranjinha, C. Mateus, W. Lemahieu, A.B. Dirim, E. Demir, S. A afak, A. Turkmen, D.A.M.J. Hollander, S. Buttner, A.P.J. De Vries, S. Meziyerh, D. Van Der Helm, M. Mallat, H. Bouwsma, S. Sridharan, K. Petruliene, S.-. Maloney, I. Verberk, F.M. Van Der Sande, M.H.L. Christiaans, M. Hemmelder, M.N. Kumar, M. Di Luca, S.Z. Tuglular, A. Kramer, C. Beerenhout, P.T. Luik, J. Kerschbaum, M. Tiefenthaler, A.Y. Adema, V.A. Stepanov, A.B. Zulkarnaev, K. Turkmen, A. Fliedner, A. Asberg, G. Mjoen, H. Miyasato, C.W.H. De Fijter, N. Mongera, S. Pini, C. De Biase, R. Duivenvoorden, L. Hilbrands, A. Kerckhoffs, R. Maas, O. Lebedeva, V. Lopez, J. Verhave, D. Titov, E.V. Parshina, L. Zanoli, C. Marcantoni, L.E.A. Van Gils-Verrij, J.C. Harty, M. Meurs, M. Myslak, Y. Battaglia, E. Den Deurwaarder, M. Stendahl, H. Rahimzadeh, M. Schouten, I. Rychlik, C.J. Cabezas-Reina, A.M. Roca, F. Nauta, N. Kanaan, L. Labriola, A. Devresse, A. Diaz-Mareque, A. Coca, B.K.I. Meijers, M. Naesens, D. Kuypers, B. Desschans, A. Tonnelier, K.M. Wissing, G. De Arriba, I. Dedinska, G. Pessolano, I. Gandolfini, U. Maggiore, E. Papachristou, C.F.M. Franssen, S.P. Berger, E. Meijer, A. Ozyilmaz, J.S.F. Sanders, J.B. Ponikvar, A.M. Pernat, D. Kovac, R. Ekart, A.C. Abrahams, F.M. Molenaar, A.D. Van Zuilen, S.C.A. Meijvis, H. Dolmans, E. Tantisattamos, P. Esposito, J.-. Krzesinski, J.D. Barahira, M. Gallieni, G. Sabiu, P.L. Martin-Moreno, G. Guglielmetti, G. Guzzo, N. Toapanta, A.J. Luik, W.H.M. Van Kuijk, L.W.H. Stikkelbroeck, M.M.H. Hermans, L. Rimsevicius, M. Righetti, M. Islam, N.H.-. Braak. - In: NEPHROLOGY DIALYSIS TRANSPLANTATION. - ISSN 0931-0509. - 36:11(2021 Nov), pp. 2094-2105. [10.1093/ndt/gfab200]

COVID-19-related mortality in kidney transplant and haemodialysis patients: A comparative, prospective registry-based study

Goffin E.;Candellier A.;Vart P.;Noordzij M.;Arnol M.;Covic A.;Lentini P.;Malik S.;Reichert L. J.;Sever M. S.;Watschinger B.;Jager K. J.;Gansevoort R. T.;Van Der Net J. B.;Essig M.;Du Buf-Vereijken P. W. G.;Van Ginneken B.;Vogt L.;Van Jaarsveld B. C.;Bemelman F. J.;Klingenberg-Salahova F.;Heenan-Vos F.;Vervloet M. G.;Nurmohamed A.;Abramowicz D.;Verhofstede S.;Maoujoud O.;Malfait T.;Avitum B. B.;Fialova J.;Melilli E.;Fava A.;Cruzado J. M.;Perez N. M.;Lips J.;Krepel H.;Adilovic H.;Hengst M.;Rydzewski A.;Gellert R.;Oliveira J.;Alferes D. G.;Zakharova E. V.;Ambuehl P. M.;Walker A.;Winzeler R.;Lepeytre F.;Rabate C.;Rostoker G.;Marques S.;Azasevac T.;Katicic D.;Ten Dam M.;Kruger T.;Brzosko S.;Zanen A. L.;Logtenberg S. J. J.;Fricke L.;Slebe J. J. P.;Kemlin D.;Van De Wetering J.;Reinders M. E. J.;Eiselt J.;Kielberger L.;El-Wakil H. S.;Verhoeven M. A. M.;Canal C.;Facundo C.;Ramos A. M.;Debska-Slizien A.;Veldhuizen N. M. H.;Tigka E.;Konsta M. A. P.;Panagoutsos S.;Mallamaci F.;Matceac I.;Nistor I.;Cordos M.;Groeneveld J. H. M.;Jousma J.;Van Buren M.;Elhafeez S. A.;Diekmann F.;Pereira T. A.;Santos A. C. S.;Arias-Cabrales C.;Crespo M.;Llinas-Mallol L.;Buxeda A.;Tarrega C. B.;Redondo-Pachon D.;Jimenez M. D. A.;Hofstra J. M.;Franco A.;Arroyo D.;Rodriguez-Ferrero M. L.;Manzanos S. B.;Barrios R. H. S.;Avila G.;Laranjinha I.;Mateus C.;Lemahieu W.;Dirim A. B.;Demir E.;A afak S.;Turkmen A.;Hollander D. A. M. J.;Buttner S.;De Vries A. P. J.;Meziyerh S.;Van Der Helm D.;Mallat M.;Bouwsma H.;Sridharan S.;Petruliene K.;Maloney S. -R.;Verberk I.;Van Der Sande F. M.;Christiaans M. H. L.;Hemmelder M.;Kumar M. N.;M. Di Luca;Tuglular S. Z.;Kramer A.;Beerenhout C.;Luik P. T.;Kerschbaum J.;Tiefenthaler M.;Adema A. Y.;Stepanov V. A.;Zulkarnaev A. B.;Turkmen K.;Fliedner A.;Asberg A.;Mjoen G.;Miyasato H.;De Fijter C. W. H.;Mongera N.;Pini S.;De Biase C.;Duivenvoorden R.;Hilbrands L.;Kerckhoffs A.;Maas R.;Lebedeva O.;Lopez V.;Verhave J.;Titov D.;Parshina E. V.;Zanoli L.;Marcantoni C.;Van Gils-Verrij L. E. A.;Harty J. C.;Meurs M.;Myslak M.;Battaglia Y.;Den Deurwaarder E.;Stendahl M.;Rahimzadeh H.;Schouten M.;Rychlik I.;Cabezas-Reina C. J.;Roca A. M.;Nauta F.;Kanaan N.;Labriola L.;Devresse A.;Diaz-Mareque A.;Coca A.;Meijers B. K. I.;Naesens M.;Kuypers D.;Desschans B.;Tonnelier A.;Wissing K. M.;De Arriba G.;Dedinska I.;Pessolano G.;Gandolfini I.;Maggiore U.;Papachristou E.;Franssen C. F. M.;Berger S. P.;Meijer E.;Ozyilmaz A.;Sanders J. S. F.;Ponikvar J. B.;Pernat A. M.;Kovac D.;Ekart R.;Abrahams A. C.;Molenaar F. M.;Van Zuilen A. D.;Meijvis S. C. A.;Dolmans H.;Tantisattamos E.;P. Esposito;Krzesinski J. -M.;Barahira J. D.;M. Gallieni;G. Sabiu;Martin-Moreno P. L.;Guglielmetti G.;Guzzo G.;Toapanta N.;Luik A. J.;Van Kuijk W. H. M.;Stikkelbroeck L. W. H.;Hermans M. M. H.;Rimsevicius L.;Righetti M.;Islam M.;Braak N. H. -T.

2021

Abstract

Background: Coronavirus disease 2019 (COVID-19) has exposed haemodialysis (HD) patients and kidney transplant (KT) recipients to an unprecedented life-threatening infectious disease, raising concerns about kidney replacement therapy (KRT) strategy during the pandemic. This study investigated the association of the type of KRT with COVID-19 severity, adjusting for differences in individual characteristics. Methods: Data on KT recipients and HD patients diagnosed with COVID-19 between 1 February 2020 and 1 December 2020 were retrieved from the European Renal Association COVID-19 Database. Cox regression models adjusted for age, sex, frailty and comorbidities were used to estimate hazard ratios (HRs) for 28-day mortality risk in all patients and in the subsets that were tested because of symptoms. Results: A total of 1670 patients (496 functional KT and 1174 HD) were included; 16.9% of KT and 23.9% of HD patients died within 28 days of presentation. The unadjusted 28-day mortality risk was 33% lower in KT recipients compared with HD patients {HR 0.67 [95% confidence interval (CI) 0.52-0.85]}. In a fully adjusted model, the risk was 78% higher in KT recipients [HR 1.78 (95% CI 1.22-2.61)] compared with HD patients. This association was similar in patients tested because of symptoms [fully adjusted model HR 2.00 (95% CI 1.31-3.06)]. This risk was dramatically increased during the first post-transplant year. Results were similar for other endpoints (e.g. hospitalization, intensive care unit admission and mortality >28 days) and across subgroups. Conclusions: KT recipients had a greater risk of a more severe course of COVID-19 compared with HD patients, therefore they require specific infection mitigation strategies.

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	Parole chiave
	
				COVID-19; dialysis; kidney; mortality; transplantation;
			
	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-08/B - Nefrologia
			
	Data di pubblicazione
	
				nov-2021
			
	Data ahead of print o data di stampa
	
				16-giu-2021
			
	Rivista in ANCE
	
				NEPHROLOGY DIALYSIS TRANSPLANTATION
			
	DOI
	
				https://dx.doi.org/10.1093/ndt/gfab200
			
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				01 - Articolo su periodico

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