Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons..
Mortality among patients hospitalized for COVID-19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID-19, we compared 28-day mortality between early 2020 (March 1, 2020-June 19, 2020) and late 2020 (June 20, 2020-December 31, 2020). Multivariable logistic regression was used to assess comorbidity-adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (p < .001). Crude 28-day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46-0.98, p = .016). Between the early and late periods, the use of corticosteroids (≥6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%], p < .001 and 50/571 [8.8%] vs. 213/402 [52.2%], p < .001, respectively), and the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%], p < .001 and 73/571 [12.8%] vs. 5/402 [1.2%], p < .001, respectively). Mortality among SOTR hospitalized for COVID-19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study.
Errataetall: |
CommentIn: Am J Transplant. 2022 Jan;22(1):12-13. - PMID 34738312 |
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Medienart: |
E-Artikel |
Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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Enthalten in: |
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 22(2022), 1 vom: 30. Jan., Seite 279-288 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Heldman, Madeleine R [VerfasserIn] |
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Links: |
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Themen: |
Clinical research/practice |
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Anmerkungen: |
Date Completed 05.01.2022 Date Revised 10.02.2023 published: Print-Electronic CommentIn: Am J Transplant. 2022 Jan;22(1):12-13. - PMID 34738312 Citation Status MEDLINE |
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doi: |
10.1111/ajt.16840 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM330568981 |
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500 | |a CommentIn: Am J Transplant. 2022 Jan;22(1):12-13. - PMID 34738312 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2021 The American Society of Transplantation and the American Society of Transplant Surgeons. | ||
520 | |a Mortality among patients hospitalized for COVID-19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID-19, we compared 28-day mortality between early 2020 (March 1, 2020-June 19, 2020) and late 2020 (June 20, 2020-December 31, 2020). Multivariable logistic regression was used to assess comorbidity-adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (p < .001). Crude 28-day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46-0.98, p = .016). Between the early and late periods, the use of corticosteroids (≥6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%], p < .001 and 50/571 [8.8%] vs. 213/402 [52.2%], p < .001, respectively), and the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%], p < .001 and 73/571 [12.8%] vs. 5/402 [1.2%], p < .001, respectively). Mortality among SOTR hospitalized for COVID-19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Multicenter Study | |
650 | 4 | |a clinical research/practice | |
650 | 4 | |a infection and infectious agents - viral | |
650 | 4 | |a infectious disease | |
650 | 4 | |a organ transplantation in general | |
650 | 4 | |a quality of care/care delivery | |
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700 | 1 | |a Georgia, Sarah J |e verfasserin |4 aut | |
700 | 1 | |a Steinbrink, Julie M |e verfasserin |4 aut | |
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700 | 1 | |a Hemmige, Vagish |e verfasserin |4 aut | |
700 | 1 | |a McCort, Margaret E |e verfasserin |4 aut | |
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700 | 1 | |a Hughes Kramer, Kailey |e verfasserin |4 aut | |
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700 | 0 | |a UW COVID-19 SOT Study Team |e verfasserin |4 aut | |
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700 | 1 | |a Bennett, William |e investigator |4 oth | |
700 | 1 | |a Leandro, Jennifer |e investigator |4 oth | |
700 | 1 | |a Sait, Afrah |e investigator |4 oth | |
700 | 1 | |a Rumore, Amy |e investigator |4 oth | |
700 | 1 | |a West, Patricia |e investigator |4 oth | |
700 | 1 | |a Jeng, Amy |e investigator |4 oth | |
700 | 1 | |a Bajrovic, Valida |e investigator |4 oth | |
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700 | 1 | |a Theodoropoulos, Nicole |e investigator |4 oth | |
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