Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients - Archive ouverte HAL Access content directly
Journal Articles Kidney International Reports Year : 2022

Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients

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Marc Hazzan
  • Function : Author
Nassim Kamar
  • Function : Author
Hélène Francois
  • Function : Author
Clarisse Greze
  • Function : Author
Philippe Gatault
  • Function : Author
Pierre Westeel
  • Function : Author
Valentin Goutaudier
  • Function : Author
Renaud Snanoudj
  • Function : Author
Charlotte Colosio
  • Function : Author
Antoine Sicard
  • Function : Author
Valerie Moal
  • Function : Author
Dominique Bertrand
  • Function : Author
Christiane Mousson
  • Function : Author
Jamal Bamoulid
  • Function : Author
Paolo Malvezzi
  • Function : Author
Antoine Thierry
  • Function : Author
Agnes Duveau
  • Function : Author
Gilles Blancho
  • Function : Author
Jérôme Tourret
  • Function : Author
Christophe Mariat
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Jean-Philippe Rerolle
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Nicolas Bouvier
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Abstract

SARS-CoV-2 pandemic evolved in two consecutive waves over 2020. Improvements in the management of COVID-19 led to a reduction of mortality rates in hospitalized patients during the second wave. Whether this progress also benefited to kidney transplant recipients (KTR), a population particularly vulnerable to severe COVID-19, remained unclear. In France, 957 KTR were hospitalized for COVID-19 in 2020 and their data were prospectively collected in the French SOT COVID registry. The presentation, management, and outcomes of the 359 KTR diagnosed during the 1st wave were compared to those of the 598 of the 2nd wave. Baseline comorbidities were similar between KTR of the 2 waves. Maintenance immunosuppression was reduced in most patients but withdrawal of antimetabolite (73.7% vs 58.4%, p<0.001) or CNI (32.1% vs 16.6%, p<0.001) was less frequent during the 2nd wave. Hydroxychloroquine and azithromycin that were commonly used during the 1st wave (21.7% and 30.9%, respectively) were almost abandoned during the 2nd. In contrast, the use of high dose corticosteroids doubled (19.5% vs. 41.6%, p<0.001). Despite these changing trends in COVID-19 management, 60-day mortality was not statistically different between the 2 waves (25.3% vs. 23.9%; Log Rank, p=0.48) and COVID-19 hospitalization period was not associated with death due to COVID in multivariate analysis (HR 0.89, 95% CI 0.67 - 1.17, p = 0.4). We conclude that changing of therapeutic trends during 2020 did not reduce COVID-19 related mortality in KTR. Our data indirectly support the importance of vaccination and monoclonal neutralizing anti-SARS-CoV-2 antibodies to protect KTR from severe COVID-19.
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Dates and versions

hal-03800251 , version 1 (23-01-2023)
hal-03800251 , version 2 (23-01-2023)

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Attribution - NonCommercial - NoDerivatives - CC BY 4.0

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Cite

Bastien Berger, Marc Hazzan, Nassim Kamar, Hélène Francois, Marie Matignon, et al.. Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients. Kidney International Reports, 2022, ⟨10.1016/j.ekir.2022.09.007⟩. ⟨hal-03800251v2⟩
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