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

Autor: Lee SB; Department of Medicine, Division of Infectious Diseases, University of Saskatchewan, Regina, Canada., Dai R; Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA., French E; Virginia Commonwealth University Wright Center for Clinical and Translational Research, Richmond, Virginia, USA., Anzalone JA; Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA., Olex AL; Virginia Commonwealth University Wright Center for Clinical and Translational Research, Richmond, Virginia, USA., Ge J; Department of Medicine, Division of Gastroenterology and Hepatology, University of California, San Francisco, California, USA., Schissel M; Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA., Agarwal G; Department of Internal Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Vinson A; Department of Medicine, Division of Nephrology, Dalhousie University, Halifax, Canada., Madhira V; Palila Software, Reno, Nevada, USA., Mannon RB; Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2024 Oct; Vol. 26 (5), pp. e14333. Date of Electronic Publication: 2024 Jul 09.
DOI: 10.1111/tid.14333
Abstrakt: 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.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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