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Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic
American Journal of Transplantation ( IF 8.8 ) Pub Date : 2021-09-12 , DOI: 10.1111/ajt.16840
Madeleine R Heldman 1 , Olivia S Kates 1 , Kassem Safa 2 , Camille N Kotton 2 , Sarah J Georgia 2 , Julie M Steinbrink 3 , Barbara D Alexander 3 , Marion Hemmersbach-Miller 4 , Emily A Blumberg 5 , Ashrit Multani 6 , Brandy Haydel 7 , Ricardo M La Hoz 8 , Lisset Moni 9 , Yesabeli Condor 9 , Sandra Flores 9 , Carlos G Munoz 9 , Juan Guitierrez 9 , Esther I Diaz 9 , Daniela Diaz 9 , Rodrigo Vianna 9 , Giselle Guerra 9 , Matthias Loebe 9 , Robert M Rakita 1 , Maricar Malinis 10 , Marwan M Azar 10 , Vagish Hemmige 11 , Margaret E McCort 11 , Zohra S Chaudhry 12 , Pooja P Singh 13 , Kailey Hughes Kramer 14 , Arzu Velioglu 15 , Julie M Yabu 16 , Jose A Morillis 17 , Sapna A Mehta 18 , Sajal D Tanna 19 , Michael G Ison 19 , Ariella C Derenge 20 , David van Duin 21 , Adrienne Maximin 22 , Carlene Gilbert 23 , Jason D Goldman 1, 24 , Erika D Lease 25 , Cynthia E Fisher 1 , Ajit P Limaye 1 ,
Affiliation  

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 (< .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, = .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%], < .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.

中文翻译:

大流行期间因 COVID-19 住院的实体器官移植受者死亡率的变化趋势

在大流行期间,因 COVID-19 而住院的患者死亡率有所下降。实体器官移植受者 (SOTR) 的死亡率趋势尚不清楚。我们使用来自因 COVID-19 住院的 SOTR 多中心登记处的数据,比较了 2020 年初(2020 年 3 月 1 日至 2020 年 6 月 19 日)和 2020 年底(2020 年 6 月 20 日至 2020 年 12 月 31 日)之间的 28 天死亡率。多变量逻辑回归用于评估合并症调整后的死亡率。1435/1616 (88.8%) SOTR 的诊断时间段可用,971/1435 (67.7%) 住院:2020 年初 571/753 (75.8%) 和 2020 年底 402/682 (58.9%)(<.001)。28 天粗死亡率在早期和晚期之间有所下降(112/571 [19.6%] 对 55/402 [13.7%]),即使在调整基线合并症后,晚期仍保持较低水平(aOR 0.67,95% CI 0.46–0.98, = .016)。在早期和晚期之间,皮质类固醇(≥6 mg 地塞米松/天)和瑞德西韦的使用增加(62/571 [10.9%] 对比 243/402 [61.5%],p  < .001 和 50/571 [8.8 %] vs. 213/402 [52.2%], < .001),羟氯喹和 IL-6/IL-6 受体抑制剂的使用减少(329/571 [60.0%] vs. 4/492 [ 1.0%],p  < .001 和 73/571 [12.8%] 对比 5/402 [1.2%],p < .001,分别)。因 COVID-19 而住院的 SOTR 的死亡率在 2020 年初和末期有所下降,这与一般人群报告的趋势一致。改善生存的潜在机制需要进一步研究。
更新日期:2021-09-12
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