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In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (pinteraction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk.
Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy
Vart P.;Duivenvoorden R.;Adema A.;Covic A.;Finne P.;Braak N. H. -T.;Laine K.;Noordzij M.;Schouten M.;Jager K. J.;Gansevoort R. T.;van der Net J. B.;Essig M.;du Buf-Vereijken P. W. G.;van Ginneken B.;Maas N.;van Jaarsveld B. C.;Bemelman F. J.;Klingenberg-Salahova F.;Heenan-Vos F.;Vervloet M. G.;Nurmohamed A.;Vogt L.;Abramowicz D.;Verhofstede S.;Maoujoud O.;Malfait T.;Fialova J.;Melilli E.;Fava A.;Cruzado J. M.;Perez N. M.;Lips J.;Krepel H.;Adilovic H.;Radulescu D.;Hengst M.;Konings C.;Rydzewski A.;Braconnier P.;Weis D.;Gellert R.;Oliveira J.;Alferes D. G.;Zakharova E. V.;Ambuhl P. M.;Guidotti R.;Walker A.;Lepeytre F.;Rabate C.;Rostoker G.;Marques S.;Azasevac T.;Majstorovic G. S.;Katicic D.;ten Dam M.;Kruger T.;Brzosko S.;Liakopoulos V.;Zanen A. L.;Logtenberg S. J. J.;Fricke L.;Kuryata O.;Slebe J. J. P.;ElHafeez S. A.;Kemlin D.;van de Wetering J.;Reinders M. E. J.;Hesselink D. A.;Kal-van Gestel J.;Eiselt J.;Kielberger L.;El-Wakil H. S.;Verhoeven M.;Logan I.;Canal C.;Facundo C.;Ramos A. M.;Debska-Slizien A.;Veldhuizen N. M. H.;Tigka E.;Konsta M. A. P.;Panagoutsos S.;Mallamaci F.;Postorino A.;Cambareri F.;Matceac I.;Nistor I.;Groeneveld J. H. M.;Jousma J.;van Buren M.;Diekmann F.;Oppenheimer F.;Blasco M.;Pereira T. A.;Santos A. C. S.;Arias-Cabrales C.;Crespo M.;Llinas-Mallol L.;Buxeda A.;Tarrega C. B.;Redondo-Pachon D.;Jimenez M. D. A.;Mendoza-Valderrey A.;Martins A. C.;Mateus C.;Alvila G.;Laranjinha I.;Hofstra J. M.;Siezenga M. A.;Franco A.;Arroyo D.;Castellano S.;Rodriguez-Ferrero M. L.;Manzanos S. B.;Barrios R. H. S.;Lemahieu W.;Bartelet K.;Dirim A. B.;Demir E.;Sever M. S.;Turkmen A.;Safak S.;Hollander D. A. M. J.;Buttner S.;de Vries A. P. J.;Meziyerh S.;van der Helm D.;Mallat M.;Bouwsma H.;Sridharan S.;Petruliene K.;Maloney S. -R.;Verberk I.;van der Sande F. M.;Christiaans M. H. L.;Hemmelder M. H.;MohanKumar N.;Di Luca M.;Tuglular S. Z.;Kramer A. B.;Beerenhout C.;Luik P. T.;Kerschbaum J.;Tiefenthaler M.;Watschinger B.;Stepanov V. A.;Zulkarnaev A. B.;Turkmen K.;Gandolfini I.;Maggiore U.;Fliedner A.;Asberg A.;Mjoen G.;Miyasato H.;de Fijter C. W. H.;Mongera N.;Pini S.;de Biase C.;Kerckhoffs A.;van de Logt A. E.;Maas R.;Hilbrands L. B.;Lebedeva O.;Lopez V.;Reichert L. J. M.;Verhave J.;Titov D.;Parshina E. V.;Zanoli L.;Marcantoni C.;van Kempen G.;van Gils-Verrij L. E. A.;Harty J. C.;Meurs M.;Myslak M.;Battaglia Y.;Lentini P.;den Deurwaarder E.;Stendahl M.;Rahimzadeh H.;Rychlik I.;Cabezas-Reina C. J.;Roca A. M.;Nauta F.;Sahin I.;Goffin E.;Kanaan N.;Labriola L.;Devresse A.;Diaz-Mareque A.;Coca A.;de Arriba G.;Meijers B. K. I.;Naesens M.;Kuypers D.;Desschans B.;Tonnerlier A.;Wissing K. M.;Dedinska I.;Pessolano G.;Malik S.;Dounousi E.;Papachristou E.;Berger S. P.;Sanders J. S. F.;Franssen C. F. M.;Ozyilmaz A.;Ponikvar J. B.;Pernat A. M.;Kovac D.;Arnol M.;Ekart R.;Abrahams A. C.;Molenaar F. M.;van Zuilen A. D.;Meijvis S. C. A.;Dolmans H.;Tantisattamo E.;Esposito P.;Krzesinski J. -M.;Barahira J. D.;Gallieni M.;Martin-Moreno P. L.;Guglielmetti G.;Guzzo G.;Toapanta N.;Soler M. J.;Luik A. J.;van Kuijk W. H. M.;Stikkelbroeck L. W. H.;Hermans M. M. H.;Rimsevicius L.;Righetti M.;Islam M.
2022-01-01
Abstract
In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (pinteraction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/540099
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2021-2023 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
