%0 Journal Article
%A Villanego, Florentino
%A Mazuecos, Auxiliadora
%A Perez-Flores, Isabel M
%A Moreso, Francesc
%A Andres, Amado
%A Jimenez-Martinn, Carlos
%A Molina, Maria
%A Canal, Cristina
%A Sanchez-Camara, Luis A
%A Zarraga, Sofía
%A Ruiz-Fuentes, Maria Del Carmen
%A Aladren, Maria Jose
%A Melilli, Edoardo
%A Lopez, Veronica
%A Sanchez-Alvarez, Emilio
%A Crespo, Marta
%A Pascual, Julio
%T Predictors of severe COVID-19 in kidney transplant recipients in the different epidemic waves: Analysis of the Spanish Registry.
%D 2021
%U http://hdl.handle.net/10668/17389
%X SARS-CoV-2 infection has produced high mortality in kidney transplant (KT) recipients, especially in the elderly. Until December 2020, 1011 KT with COVID-19 have been prospectively included in the Spanish Registry and followed until recovery or death. In multivariable analysis, age, pneumonia, and KT performed ≤6 months before COVID-19 were predictors of death, whereas gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups according to recipient age and time after KT (age 6 months, age 6 and age ≥65 and time ≤6): mortality rates were, respectively, 11.3%, 24.5%, 35.4%, and 54.5% (p < .001). Patients were significantly younger, presented less pneumonia, and received less frequently specific anti- COVID- 19 treatment in the second wave (July– December) than in the first one (March– June). Overall mortality was lower in the second wave (15.1 vs. 27.4%, p < .001) but similar in critical patients (66.7% vs. 58.1%, p = .29). The interaction between age and time post- KT should be considered when selecting recipients for transplantation in the COVID- 19 pandemic. Advanced age and a recent KT should foster strict protective measures, including vaccination.
%K Clinical research/practice
%K Infection and infectious agents - viral
%K Kidney transplantation/nephrology
%K Patient survival
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