Increased Mortality in Kidney Transplant Recipients During the Delta/Omicron Era of the COVID-19 Pandemic Despite Widespread Vaccination

IF 1.9 4区 医学 Q2 SURGERY Clinical Transplantation Pub Date : 2025-01-07 DOI:10.1111/ctr.70071
Byron Smith, Sumi Nair, Hani Wadei, Martin Mai, Hasan Khamash, Carrie Schinstock, Yun Liang, Ahmed Abdelrheem, Walter Park, Andrew Badley, Mark D. Stegall
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Abstract

Introduction

The incidence of mortality late in the pandemic, particularly after widespread vaccine availability, is not well understood. Herein, we elucidate the effect of this impact of the COVID pandemic as well as risk factors for mortality during it.

Methods

The primary end point was death with a functioning graft with secondary endpoints of mortality rates in subgroups and at different time intervals during the pandemic.

Results

Despite widespread vaccination, mortality rates for kidney transplant (KTx) recipients almost doubled during the COVID-19 era (6.40 deaths per 100 person years vs. 3.54 pre-COVID). Mortality increased in all racial/ethnic groups but increased more in Native Americans, Hispanics, and African Americans compared to non-Hispanic Caucasians. The highest mortality rate occurred during the Delta and Omicron time frames. In contrast to the general population, mortality was more evenly spread across age groups in KTx recipients.

Conclusions

Mortality rates during the COVID-19 era were extremely high, more than doubling in some racial/ethnic groups. We conclude that the KTx population was a particularly vulnerable group during the COVID-19 era and suggests the need for further research into the management of variants in the future.

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在COVID-19大流行的Delta/Omicron时代,尽管广泛接种疫苗,肾移植受者的死亡率仍在增加。
导言:大流行后期的死亡率,特别是在广泛接种疫苗之后的死亡率,尚不清楚。在此,我们阐明了COVID大流行的影响以及在此期间死亡的危险因素。方法:主要终点是移植功能正常的死亡,次要终点是大流行期间亚组和不同时间间隔的死亡率。结果:尽管广泛接种疫苗,但在COVID-19时代,肾移植(KTx)受者的死亡率几乎翻了一番(每100人年死亡6.40人,而COVID-19前为3.54人)。死亡率在所有种族/民族群体中都有所增加,但与非西班牙裔白人相比,美洲原住民、西班牙裔和非洲裔美国人的死亡率增加更多。死亡率最高的是“德尔塔”和“欧米克隆”时期。与一般人群相比,KTx接受者的死亡率在各年龄组之间分布更为均匀。结论:COVID-19时期的死亡率非常高,在一些种族/族裔群体中增加了一倍以上。我们得出结论,在COVID-19时代,KTx人群是一个特别脆弱的群体,并建议未来需要进一步研究变异的管理。
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来源期刊
Clinical Transplantation
Clinical Transplantation 医学-外科
CiteScore
3.70
自引率
4.80%
发文量
286
审稿时长
2 months
期刊介绍: Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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