Article Dans Une Revue American Journal of Transplantation Année : 2021

Is COVID‐19 infection more severe in kidney transplant recipients?

1 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
2 IRM - Immuno-Rhumatologie Moléculaire
3 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
4 CHU Tenon [AP-HP]
5 IMRB - Institut Mondor de Recherche Biomédicale
6 CHU Henri Mondor [Créteil]
7 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
8 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
9 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
10 UT - Université de Tours
11 Hôpital Edouard Herriot [CHU - HCL]
12 CIRI - Centre International de Recherche en Infectiologie
13 CIRI-NOPAB - Cellules B normales et pathogéniques - Normal and pathogenic B cell responses [CIRI]
14 UCBL - Université Claude Bernard Lyon 1
15 Service de Transplantation, Néphrologie et Immunologie Clinique [Lyon]
16 AMU - Aix Marseille Université
17 Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy
18 Service de Néphrologie [CHRU Nancy]
19 CHU Amiens-Picardie
20 CHU Montpellier = Montpellier University Hospital
21 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
22 CHU Reims - Hôpital universitaire Robert Debré [Reims]
23 UR2CA - Unité de Recherche Clinique Côte d’Azur
24 CHU - Hôpital Pasteur [Nice]
25 UNIROUEN - Université de Rouen Normandie
26 UB - Université de Bourgogne
27 UFC - Université de Franche-Comté
28 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
29 UP - Université de Poitiers = University of Poitiers
30 ImmunoConcept - Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle
31 CHU de Bordeaux Pellegrin [Bordeaux]
32 CIC - Centre d'Investigation Clinique [Rennes]
33 Irset - Institut de recherche en santé, environnement et travail
34 UA - Université d'Angers
35 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
36 MEPHI - Microbes Evolution Phylogénie et Infections
37 LBAI - Lymphocytes B, Autoimmunité et Immunothérapies
38 CHU - BREST - Nephrologie - CHRU Brest - Service de Nephrologie
39 LabEX IGO Immunothérapie Grand Ouest
40 Université de Lille
Philippe Gatault
Pierre Westeel
  • Fonction : Auteur
  • PersonId : 1526672
  • IdRef : 074256262
Christiane Mousson
Marc Hazzan

Résumé

There are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients

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Dates et versions

hal-03371189 , version 1 (18-10-2021)

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Sophie Caillard, Nathalie Chavarot, Hélène Francois, Marie Matignon, Clarisse Greze, et al.. Is COVID‐19 infection more severe in kidney transplant recipients?. American Journal of Transplantation, 2021, 21 (3), pp.1295-1303. ⟨10.1111/ajt.16424⟩. ⟨hal-03371189⟩
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