Mortality risk factors in kidney‐transplanted patients with COVID‐19: A systematic review and regression analysis

Abstract

Background and aims The kidney transplant patients who receive immunosuppressive and specific medication may lead to different mortality risk factors between kidney transplant patients with COVID‐19 and the general population. We aimed to provide a model predictor and a risk analysis of mortality in kidney transplant COVID‐19 positive patients. Methods We performed our search using PubMed, MEDLINE, Web of Science, Scopus, and Google Scholar to identify English articles published from the beginning of December 2019 through August 2020. Excluded manuscripts had no full text, lacked information, were not the original article, or consisted of less than three cases. We gathered information about demographic information, comorbidities, COVID‐19 symptoms, lung radiographic findings, history of medication therapy, and changes in the kidney maintenance therapy after confirming their COVID‐19 on the data extraction forms. Results We found a total of 31 eligible articles. We set a 10% mortality rate as our cutoff point. The most common sign and symptoms were cough (53.22 [29.42]), dyspnea (50.80 [24.55]). In the bivariate analysis, fatigue (P = .04, OR of 0.92; 95% CI: 0.85‐1.00), hypertension (P = .07, OR of 1.03; 95% CI: 1.00‐1.07), and dyspnea (P = .08, OR of 1.04; 95% CI: 1.00‐1.09) showed a statistically significant relationship with increases in mortality. In multivariate regression analysis, an independent association was only found between hypertension and mortality (P = .035; AOR of 1.064; CL: 1.004‐1.127). Conclusion Clinicians should pay special attention to modifiable risk factors for COVID‐19 infection mortality, such as hypertension among kidney transplant patients, because it may be possible to decrease mortality by controlling these factors.

Infección por covid-19 en pacientes con trasplante renal

“…En la caracterización de nuestra población con trasplante renal, se encontró que las comorbilidades más frecuentes fueron hipertensión arterial, enfermedad tiroidea y diabetes mellitus. En la literatura mundial se han descrito la hipertensión arterial y la diabetes mellitus como factores de riesgo para mortalidad y severidad en COVID-19 en receptores de trasplante renal (18)(19)(20)(21)(22)(23). Encontramos también que la presentación clínica de la COVID-19 en pacientes trasplantados, es similar a la reportada en la población general, en la que predominan la fiebre y los síntomas respiratorios.…”

A comparison of antibody response in kidney transplant recipients and healthcare workers who had PCR-confirmed COVID-19 infection

“…Several studies have reported that kidney transplant recipients with COVID-19 have a high mortality rate as high as 40% [ 1 – 6 ]. It has been shown that increasing age and the presence of comorbid diseases are associated with an increased risk of mortality [ 21 , 22 ]. In our study, all kidney transplant recipients recovered except one.…”

COVID-19 Outcomes in Kidney Transplant Recipients in a German Transplant Center

“…The World Health Organization (WHO) proclaimed the Coronavirus disease 2019 (COVID-19) as a global pandemic in March 2020 [ 1 ]. The rapid emergence and subsequent dominance of new variants on a global scale have become characteristic features of SARS-CoV-2 [ 2 ].…”