Excess Mortality in Kidney and Kidney-Pancreas Transplant Recipients in the COVID-19 Pandemic in Portugal—A Cohort Study

Autor: Miguel T. Coimbra, José A. T. S. Francisco, Joana C. Freitas, Renata V. Carvalho, Sara R. B. Vilela, Catarina I. C. D. Ribeiro, José L. C. S. L. Silvano, Sofia Pedroso, Manuela Almeida, La Salete Martins, Jorge Malheiro
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Transplant International, Vol 36 (2023)
Druh dokumentu: article
ISSN: 1432-2277
DOI: 10.3389/ti.2023.11655
Popis: The COVID-19 pandemic increased morbidity and mortality worldwide, particularly in the Kidney and Kidney-Pancreas Transplant Recipient (KTR/KPTR) population. Aiming at assessing the absolute and relative excess mortality (EM) in a Portuguese KTR/KPTR cohort, we conducted a retrospective observational study of two KTR/KPTRs cohorts: cohort 1 (P1; n = 2,179) between September/2012 and March/2020; cohort 2 (P2; n = 2067) between March/2020, and August/2022. A correlation between relative and absolute EM and age, sex, time from transplantation and cause of death was explored. A total of 145 and 84 deaths by all causes were observed in P1 and P2, respectively. The absolute EM in P2 versus P1 was 19.2 deaths (observed/expected mortality ratio 1.30, p = 0.006), and the relative EM was 1.47/1,000 person-months (95% CI 1.11–1.93, p = 0.006). Compared to the same period in the general population, the standardized mortality rate by age in P2 was 3.86 (95% CI 2.40–5.31), with a peak at 9.00 (95% CI 4.84–13.16) in P2C. The higher EM identified in this population was associated, mainly, with COVID-19 infection, with much higher values during the second seasonal COVID-19 peak when compared to the general population, despite generalized vaccination. These highlight the need for further preventive measures and improved therapies in these patients.
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