AUTHOR=Sandes-Freitas Tainá Veras de , Cristelli Marina Pontello , Requião-Moura Lucio Roberto , Modelli de Andrade Luís Gustavo , Viana Laila Almeida , Garcia Valter Duro , de Oliveira Claudia Maria Costa , Esmeraldo Ronaldo de Matos , de Lima Paula Roberta , Charpiot Ida Maria Maximina Fernandes , Ferreira Teresa Cristina Alves , Franco Rodrigo Fontanive , Costa Kellen Micheline Alves Henrique , Simão Denise Rodrigues , Ferreira Gustavo Fernandes , Santana Viviane Brandão Bandeira de Mello , Almeida Ricardo Augusto Monteiro de Barros , Deboni Luciane Monica , Saldanha Anita Leme da Rocha , Noronha Irene de Lourdes , Oliveira Lívia Cláudio de , Carvalho Deise De Boni Monteiro de , Oriá Reinaldo Barreto , Medina-Pestana Jose Osmar , Tedesco-Silva Junior Helio 

TITLE=Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10205

DOI=10.3389/ti.2022.10205

ISSN=1432-2277

ABSTRACT=Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1:<72 days; Q2:72-104 days; Q3:105-140 days; Q4:>140 days after the index case). The 28-day fatality decreased from 29.5% (Q1) to 18.8% (Q4) (pfor-trend=0.004). In multivariable analysis, patients diagnosed in Q4 showed a 35% reduced risk of death. The trend of reducing fatality was associated with a lower number of comorbidities (20.7% to 10.6%, pfor-trend=0.002), younger age (55 to 53 years, pfor-trend=0.062), and better baseline renal function (43.6 to 47.7ml/min/1.73m2, pfor-trend=0.060), and were confirmed by multivariable analysis. The proportion of patients presenting dyspnea (pfor-trend=0.001) and hypoxemia (pfor-trend<0.001) at diagnosis, and requiring intensive care was also found reduced (pfor-trend=0.038). Despite possible confounding variables and time-dependent sampling differences, we conclude that COVID-19-associated fatality decreased over time. Differences in demographics, clinical presentation, and treatment options might be involved.