Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients - Cancéropôle du Grand Est Accéder directement au contenu
Article Dans Une Revue Kidney International Reports Année : 2022

Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients

Jamal Bamoulid
  • Fonction : Auteur
Paolo Malvezzi
  • Fonction : Auteur
Antoine Thierry
  • Fonction : Auteur
Agnes Duveau
  • Fonction : Auteur
Valerie Moal
  • Fonction : Auteur
Gilles Blancho
  • Fonction : Auteur
Jérôme Tourret
  • Fonction : Auteur
Christophe Mariat
  • Fonction : Auteur
Jean-Philippe Rerolle
  • Fonction : Auteur
Nicolas Bouvier
  • Fonction : Auteur

Résumé

Introduction - SARS-CoV-2 pandemic evolved in 2 consecutive waves during 2020. Improvements in the management of COVID-19 led to a reduction in mortality rates among hospitalized patients during the second wave. Whether this progress benefited kidney transplant recipients (KTRs), a population particularly vulnerable to severe COVID-19, remained unclear. Methods - In France, 957 KTRs were hospitalized for COVID-19 in 2020 and their data were prospectively collected into the French Solid Organ Transplant (SOT) COVID registry. The presentation, management, and outcomes of the 359 KTRs diagnosed during the first wave were compared to those of the 598 of the second wave. Results - Baseline comorbidities were similar between KTRs of the 2 waves. Maintenance immunosuppression was reduced in most patients but withdrawal of antimetabolite (73.7% vs. 58.4%,  < 0.001) or calcineurin inhibitor (32.1% vs. 16.6%,  < 0.001) was less frequent during the second wave. Hydroxychloroquine and azithromycin that were commonly used during the first wave (21.7% and 30.9%, respectively) but were almost abandoned during the second wave. In contrast, the use of high dose corticosteroids doubled (19.5% vs. 41.6%,  < 0.001). Despite these changing trends in COVID-19 management, 60-day mortality was not statistically different between the 2 waves (25.3% vs. 23.9%; Log Rank,  = 0.48) and COVID-19 hospitalization period was not associated with death due to COVID-19 in multivariate analysis (Hazard ratio 0.89, 95% confidence interval 0.67-1.17,  = 0.4). Conclusion - We conclude that changing of therapeutic trends during 2020 did not reduce COVID-19 related mortality among KTRs. Our data indirectly support the importance of vaccination and neutralizing monoclonal anti-SARS-CoV-2 antibodies to protect KTRS from severe COVID-19.

Mots clés

Fichier principal
Vignette du fichier
Berger_1-s2.0-S2468024922017685-main.pdf (1.36 Mo) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-03800251 , version 1 (23-01-2023)
hal-03800251 , version 2 (23-01-2023)

Licence

Paternité - Pas d'utilisation commerciale - Pas de modification

Identifiants

Citer

Bastien Berger, Marc Hazzan, Nassim Kamar, Hélène Francois, Marie Matignon, et al.. Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients. Kidney International Reports, 2022, 7 (12), pp.2617-2629. ⟨10.1016/j.ekir.2022.09.007⟩. ⟨hal-03800251v2⟩
86 Consultations
31 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More