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Predictors of severe COVID‐19 in kidney transplant recipients in the different epidemic waves: Analysis of the Spanish Registry

American Journal of Transplantation Mar 29, 2021

Villanego F, Mazuecos A, Pérez‐Flores IM, et al. - Since kidney transplant (KT) recipients, especially elderly ones, have experienced high mortality due to SARS‐CoV‐2 infection, so, researchers analyzed 1,011 KT with COVID‐19 who were prospectively included, until December‐2020, in the Spanish Registry and observed until recovery or death. As revealed by multivariable analysis, predictors of death included: age, pneumonia and KT conducted ≤6 months prior to COVID‐19, and gastrointestinal symptoms were identified to be protective. In four subgroups by recipient age and time post-KT (age < 65 years and posttransplant time > 6 months, age < 65 and time ≤ 6, age ≥ 65 and time > 6 and age ≥ 65 and time ≤ 6), significant increasing death risk was evident: estimated mortality rates were, respectively, 11.3%, 24.5%, 35.4% and 54.5%. Findings revealed lower overall mortality in the second wave (15.1 vs 27.4%), but it was noted to be similar in critical patients (66.7% vs 58.1%). Considering the interaction between age and time after KT is advised when choosing recipients for transplantation in the COVID‐19 pandemic. It was inferred that advanced age and a recent KT should foster strict prophylactic measures, including vaccination.

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