High mortality among kidney transplant recipients diagnosed with coronavirus disease 2019: Results from the Brazilian multicenter cohort study

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Autor(es): dc.contributorUniversidade de São Paulo (USP)-
Autor(es): dc.contributorFundação Oswaldo Ramos-
Autor(es): dc.contributorHospital Israelita Albert Einstein-
Autor(es): dc.contributorFederal University of Ceará-
Autor(es): dc.contributorHospital Universitário Walter Cantídio-
Autor(es): dc.contributorHospital Geral de Fortaleza-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorSanta Casa de Misericórdia dePorto Alegre-
Autor(es): dc.contributorMedical School FAMERP-
Autor(es): dc.contributorFederal University of Maranhão-
Autor(es): dc.contributorFederal Univertisy of Rio Grande do Sul-
Autor(es): dc.contributorOnofre Lopes University Hospital-
Autor(es): dc.contributorHospital Santa Isabel-
Autor(es): dc.contributorUniversidade Estadual de Campinas (UNICAMP)-
Autor(es): dc.contributorSanta Casa deMisericórdia de Juiz de Fora-
Autor(es): dc.contributorHospital Municipal São José (HMSJ)-
Autor(es): dc.contributorHospital Santa Marcelina-
Autor(es): dc.creatorRequião-Moura, Lúcio R.-
Autor(es): dc.creatorde Sandes-Freitas, Tainá Veras-
Autor(es): dc.creatorViana, Laila Almeida-
Autor(es): dc.creatorCristelli, Marina Pontello-
Autor(es): dc.creatorde Andrade, Luis Gustavo Modelli [UNESP]-
Autor(es): dc.creatorGarcia, Valter Duro-
Autor(es): dc.creatorde Oliveira, Claudia Maria Costa-
Autor(es): dc.creatorde Matos Esmeraldo, Ronaldo-
Autor(es): dc.creatorFilho, Mario Abbud-
Autor(es): dc.creatorPacheco-Silva, Alvaro-
Autor(es): dc.creatorSousa, Katia Cronemberger-
Autor(es): dc.creatorVicari, Alessandra Rosa-
Autor(es): dc.creatorCosta, Kellen Micheline Alves Henrique-
Autor(es): dc.creatorSimão, Denise Rodrigues-
Autor(es): dc.creatorde Sousa, Marcos Vinicius-
Autor(es): dc.creatorCampos, Juliana Bastos-
Autor(es): dc.creatorde Barros Almeida, Ricardo Augusto Monteiro [UNESP]-
Autor(es): dc.creatorDeboni, Luciane Mônica-
Autor(es): dc.creatorNeto, Miguel Moysés-
Autor(es): dc.creatorZanocco, Juliana Aparecida-
Autor(es): dc.creatorTedesco-Silva, Helio-
Autor(es): dc.creatorMedina-Pestana, José-
Data de aceite: dc.date.accessioned2022-08-04T22:11:23Z-
Data de disponibilização: dc.date.available2022-08-04T22:11:23Z-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2021-07-01-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0254822-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/222089-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/222089-
Descrição: dc.descriptionBackground Kidney transplant (KT) recipients are considered a high-risk group for unfavorable outcomes in the course of coronavirus disease 2019 (COVID-19). Aim To describe the clinical aspects and outcomes of COVID-19 among KT recipients. Methods This multicenter cohort study enrolled 1,680 KT recipients diagnosed with COVID-19 between March and November 2020, from 35 Brazilian centers. The main outcome was the 90-day cumulative incidence of death, for the entire cohort and according to acute kidney injury (AKI) and renal replacement therapy (RRT) requirement. Fatality rates were analyzed according to hospitalization, intensive care unit (ICU) admission, and mechanical ventilation (MV) requirement. Multivariable analysis was performed by logistic regression for the probability of hospitalization and death. Results The median age of the recipients was 51.3 years, 60.4% were men and 11.4% were Afro-Brazilian. Comorbidities were reported in 1,489 (88.6%), and the interval between transplantation and infection was 5.9 years. The most frequent symptoms were cough (54%), myalgia (40%), dyspnea (37%), and diarrhea (31%), whereas the clinical signs were fever (61%) and hypoxemia (13%). Hospitalization was required in 65.1%, and immunosuppressive drugs adjustments were made in 74.4% of in-hospital patients. ICU admission was required in 34.6% and MV in 24.9%. In the multivariable modeling, the variables related with the probability of hospitalization were age, hypertension, previous cardiovascular disease, recent use of high dose of steroid, and fever, dyspnea, diarrhea, and nausea or vomiting as COVID-19 symptoms. On the other hand, the variables that reduced the probability of hospitalization were time of COVID-19 symptoms, and nasal congestion, headache, arthralgia and anosmia as COVID-19 symptoms. The overall 90-day cumulative incidence of death was 21.0%. The fatality rates were 31.6%, 58.2%, and 75.5% in those who were hospitalized, admitted to the ICU, and required MV, respectively. At the time of infection, 23.2% had AKI and 23.4% required RRT in the follow-up. The cumulative incidence of death was significantly higher among recipients with AKI (36.0% vs. 19.1%, P < 0.0001) and in those who required RRT (70.8% vs. 10.1%, P < 0.0001). The variables related with the probability of death within 90 days after COVID-19 were age, time after transplantation, presence of hypertension, previous cardiovascular disease, use of tacrolimus and mycophenolate, recent use of high dose of steroids, and dyspnea as COVID-19 symptom. On the other hand, the variables that reduced the risk of death were time of symptoms, and headache and anosmia as COVID-19 symptoms. Conclusion The patients diagnosed with COVID-19 were long-term KT recipients and most of them had some comorbidities. One in every five patients died, and the rate of death was significantly higher in those with AKI, mainly when RRT was required.-
Descrição: dc.descriptionDepartment of Medicine Nephrology Division Federal University of São Paulo, SP-
Descrição: dc.descriptionDepartment of Transplantation Hospital do Rim Fundação Oswaldo Ramos, SP-
Descrição: dc.descriptionRenal Transplant Unit Hospital Israelita Albert Einstein-
Descrição: dc.descriptionDepartment of ClinicalMedicine Federal University of Ceará, CE-
Descrição: dc.descriptionHospital Universitário Walter Cantídio-
Descrição: dc.descriptionHospital Geral de Fortaleza, CE-
Descrição: dc.descriptionDepartment of InternalMedicine Universidade Estadual Paulista-UNESP, SP-
Descrição: dc.descriptionSanta Casa de Misericórdia dePorto Alegre, RS-
Descrição: dc.descriptionHospital de Base Medical School FAMERP, SP-
Descrição: dc.descriptionFederal University of Maranhão, MA-
Descrição: dc.descriptionHospital de Clínicas de Porto Alegre Federal Univertisy of Rio Grande do Sul, RS-
Descrição: dc.descriptionDivision of Nephrology and KidneyTransplantation Onofre Lopes University Hospital, RN-
Descrição: dc.descriptionHospital Santa Isabel, SC-
Descrição: dc.descriptionDivision of Nephrology Renal Transplant Unit Renal Transplant Research Laboratory Schoolof Medical Sciences University of Campinas–UNICAP, SP-
Descrição: dc.descriptionSanta Casa deMisericórdia de Juiz de Fora, MG-
Descrição: dc.descriptionHospital Municipal São José (HMSJ), SC-
Descrição: dc.descriptionDivision of Nephrology School of Medicine of Ribeirão Preto University of Sao Paulo, SP-
Descrição: dc.descriptionHospital Santa Marcelina-
Descrição: dc.descriptionDepartment of InternalMedicine Universidade Estadual Paulista-UNESP, SP-
Idioma: dc.languageen-
Relação: dc.relationPLoS ONE-
???dc.source???: dc.sourceScopus-
Título: dc.titleHigh mortality among kidney transplant recipients diagnosed with coronavirus disease 2019: Results from the Brazilian multicenter cohort study-
Aparece nas coleções:Repositório Institucional - Unesp

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