Title :

Association Between Maintenance Immunosuppressive Regimens and COVID-19 Mortality in Kidney Transplant Recipients.

Author(s) :

Gérard, Alexandre O. [Auteur]
Hôpital Pasteur [Nice] [CHU]
Barbosa, Susana [Auteur]
Institut de pharmacologie moléculaire et cellulaire [IPMC]
Anglicheau, Dany [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Couzi, Lionel [Auteur]
CHU de Bordeaux Pellegrin [Bordeaux]
Hazzan, Marc [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Thaunat, Olivier [Auteur]
Hospices Civils de Lyon [HCL]
Blancho, Gilles [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Caillard, Sophie [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Sicard, Antoine [Auteur]
Laboratoire de PhysioMédecine Moléculaire [LP2M]

Journal title :

Transplantation

Abbreviated title :

Transplantation

Volume number :

106

Pages :

2063-2067

Publication date :

2022-07-29

ISSN :

1534-6080

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background. Solid organ transplant recipients are at high risk for fatal forms of coronavirus disease 2019 (COVID-19). We conducted a cohort study among kidney transplant (KT) recipients from the French Solid Organ ...
Show more >Background. Solid organ transplant recipients are at high risk for fatal forms of coronavirus disease 2019 (COVID-19). We conducted a cohort study among kidney transplant (KT) recipients from the French Solid Organ Transplant COVID-19 Registry to investigate the association between maintenance immunosuppressive drugs and 60-d mortality. Methods. Data from all KT recipients with COVID-19 included in the French Solid Organ Transplant COVID-19 Registry between February 28, 2020, and December 30, 2020, were retrieved. We evaluated associations between immunosuppressive drugs and death within 60 d using logistic regression, with all baseline characteristics considered to influence outcome or immunosuppressive regimen. The Benjamini-Hochberg correction was used for controlling false positive rate; 40 multiple imputations were performed. Adjusted P value <0.05 was considered statistically significant. Results. There were 1451 KT recipients included. Median age was 58 y, and 66.4% were men. Most frequent comorbidities were hypertension (81.9%), diabetes (34.5%), and cardiovascular disease (29.5%). Median time since transplant was 71 mo. Maintenance immunosuppression regimens included calcineurin inhibitors (1295, 89.2%), antimetabolites (1205, 83%), corticosteroids (1094, 75.4%), mammalian target of rapamycin inhibitors (144, 9.9%), and belatacept (58, 4.0%). Among 1451 transplant recipients, 201 (13.9%) died within 60 d. Older age and higher baseline serum creatinine were associated with mortality (odds ratios, 1.09 [1.07-1.11] and 1.01 [1.005-1.009], P < 0.001). Corticosteroid-free regimens were associated with a significantly lower risk of death (odds ratio, 0.48 [0.31-0.76]; P = 0.011). Conclusions. Corticosteroid-free regimens were associated with a lower risk of death in KT recipients with COVID-19. Long-term exposure to corticosteroids impairs immune functions and may predispose solid organ transplant recipients to severe forms of COVID-19.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T00:59:03Z
2024-03-25T15:55:58Z