Risk factors for severe outcomes of coronavirus disease 2019 through the waves of the pandemic: Comparing patients with and without solid organ transplantation.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI:10.1111/tid.14333

Stephen B Lee, Ran Dai, Evan French, Jerrod A Anzalone, Amy L Olex, Jin Ge, Makayla Schissel, Gaurav Agarwal, Amanda Vinson, Vithal Madhira, Roslyn B Mannon

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引用次数: 0

Abstract

Background: While coronavirus disease 2019 (COVID-19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic.

Methods: Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID-19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID-19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT.

Results: A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID-19-associated outcomes over time. In both non-SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID-19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group.

Conclusions: Our study provides a longitudinal view of the risks associated with adverse COVID-related outcomes amongst SOT and non-SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high-risk patients.

查看原文本刊更多论文

2019年冠状病毒疾病大流行期间出现严重后果的风险因素：比较接受和未接受实体器官移植的患者。

背景：虽然2019年冠状病毒病（COVID-19）已不再是公共卫生紧急事件，但某些患者仍面临严重后果的风险。为了更好地了解不断变化的风险概况，我们研究了在这一流行病的各个波次中接受和未接受实体器官移植（SOT）的患者的风险因素：我们利用国家 COVID 队列协作组研究了 2020 年 1 月 1 日至 2022 年 5 月 2 日期间 COVID-19 检测呈阳性的成年患者队列。根据美国疾病控制中心的定义，我们将数据分为 COVID-19 波。在主要结果中，我们使用了多变量生存分析来研究SOT患者和非SOT患者住院的各种风险因素：共采集了 3,570,032 名患者的数据。我们发现，随着时间的推移，COVID-19 相关不良后果的总体风险有所降低。在非 SOT 和 SOT 群体中，糖尿病、慢性肾病和充血性心力衰竭都是住院的风险因素。具体到 SOT，移植与 COVID-19 之间的较长时间具有保护作用，而年龄则是一个风险因素。值得注意的是，在这两组患者中，哮喘都不是主要不良肾脏心血管事件、住院或死亡的风险因素：我们的研究提供了一个纵向视角，反映了SOT和非SOT患者中与COVID相关不良结局有关的风险，以及这些风险因素是如何随时间演变的。我们的工作将有助于为医疗服务提供者和政策制定者提供信息，从而更好地针对高风险患者进行治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.