Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy. / ERACODA Collaborators ; Паршина, Екатерина Викторовна.
In: Scientific Reports, No. 12, 17978, 26.10.2022.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy
AU - ERACODA Collaborators
AU - Vart, Priya
AU - Duivenvoorden, Raphaël
AU - Adema, Aaltje
AU - Covic, Adrian
AU - Finne, Patrik
AU - Braak, Nicole Heijtink-ter
AU - Laine, Kaisa
AU - Noordzij, Marlies
AU - Schouten, Marcel
AU - Jager, Kitty J.
AU - Gansevoort, Ron T.
AU - van der Net, Jeroen B.
AU - Essig, Marie
AU - du Buf-Vereijken, Peggy W. G.
AU - van Ginneken, Betty
AU - Maas, Nanda
AU - van Jaarsveld, Brigit C.
AU - Bemelman, Frederike J.
AU - Klingenberg-Salahova, Farah
AU - Heenan-Vos, Frederiek
AU - Vervloet, Marc G.
AU - Nurmohamed, Azam
AU - Vogt, Liffert
AU - Abramowicz, Daniel
AU - Verhofstede, Sabine
AU - Maoujoud, Omar
AU - Malfait, Thomas
AU - Fialova, Jana
AU - Melilli, Edoardo
AU - Favà, Alexandre
AU - Cruzado, Josep M.
AU - Perez, Nuria Montero
AU - Lips, Joy
AU - Krepel, Harmen
AU - Adilovic, Harun
AU - Radulescu, Daniela
AU - Hengst, Maaike
AU - Konings, Constantijn
AU - Rydzewski, Andrzej
AU - Braconnier, Philippe
AU - Weis, Daniel
AU - Gellert, Ryszard
AU - Oliveira, João
AU - Alferes, Daniela G.
AU - Zakharova, Elena V.
AU - Ambühl, Patrice Max
AU - Guidotti, Rebecca
AU - Walker, Andrea
AU - Lepeytre, Fanny
AU - Rabaté, Clémentine
AU - Паршина, Екатерина Викторовна
PY - 2022/10/26
Y1 - 2022/10/26
N2 - 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.
AB - 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.
U2 - 10.1038/s41598-022-22657-4
DO - 10.1038/s41598-022-22657-4
M3 - Article
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 12
M1 - 17978
ER -
ID: 105318710