COVID‐19 mortality among kidney transplant candidates is strongly associated with social determinants of health
| Autor: | Sumit Mohan, Laura D. Buccini, S. Ali Husain, Kristen L. King, Jesse D. Schold, Emilio D. Poggio |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
infection and infectious agents Social Determinants of Health kidney disease ethnicity/race kidney transplantation/nephrology waitlist management 030230 surgery Brief Communication clinical research/practice 03 medical and health sciences 0302 clinical medicine Diabetes mellitus medicine Immunology and Allergy Humans Pharmacology (medical) organ transplantation in general Social determinants of health Pandemics Kidney transplantation Transplantation business.industry SARS-CoV-2 COVID-19 medicine.disease health services and outcomes research Kidney Transplantation Educational attainment United States risk assessment/risk stratification Residence business Brief Communications Body mass index Medicaid Demography Kidney disease |
| Zdroj: | American Journal of Transplantation |
| ISSN: | 1600-6143 1600-6135 |
| Popis: | The COVID‐19 pandemic has affected all portions of the global population. However, many factors have been shown to be particularly associated with COVID‐19 mortality including demographic characteristics, behavior, comorbidities, and social conditions. Kidney transplant candidates may be particularly vulnerable to COVID‐19 as many are dialysis‐dependent and have comorbid conditions. We examined factors associated with COVID‐19 mortality among kidney transplant candidates from the National Scientific Registry of Transplant Recipients from March 1 to December 1, 2020. We evaluated crude rates and multivariable incident rate ratios (IRR) of COVID‐19 mortality. There were 131 659 candidates during the study period with 3534 all‐cause deaths and 384 denoted a COVID‐19 cause (5.00/1000 person years). Factors associated with increased COVID‐19 mortality included increased age, males, higher body mass index, and diabetes. In addition, Blacks (IRR = 1.96, 95% C.I.: 1.43–2.69) and Hispanics (IRR = 3.38, 95% C.I.: 2.46–4.66) had higher COVID‐19 mortality relative to Whites. Patients with lower educational attainment, high school or less (IRR = 1.93, 95% C.I.: 1.19–3.12, relative to post‐graduate), Medicaid insurance (IRR = 1.73, 95% C.I.: 1.26–2.39, relative to private), residence in most distressed neighborhoods (fifth quintile IRR = 1.93, 95% C.I.: 1.28–2.90, relative to first quintile), and most urban and most rural had higher adjusted rates of COVID‐19 mortality. Among kidney transplant candidates in the United States, social determinants of health in addition to demographic and clinical factors are significantly associated with COVID‐19 mortality. Social factors, including educational attainment, health insurance, and residential community income levels, along with demographic and clinical characteristics, are strongly associated with mortality among kidney transplant candidates with COVID‐19 in the United States. |
| Databáze: | OpenAIRE |
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