Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

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. © 2022, The Author(s).

Авторы
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. , Favà 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. , Ambühl P.M. , Guidotti R. , Walker A. , Lepeytre F. , Rabaté C. , Rostoker G. , Marques S. , Azasevac T. , Majstorovic G.S. , Katicic D. , Ten Dam M. , Krüger 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.Jr. , Arias-Cabrales C. , Crespo M. , Llinàs-Mallol L. , Buxeda A. , Tàrrega 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. , Rodríguez-Ferrero M.L. , Manzanos S.B. , Barrios R.H.S. , Lemahieu W. , Bartelet K. , Dirim A.B. , Demir E. , Sever M.S. , Turkmen A. , Şafak S. , Hollander D.A.M.J. , Büttner 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. , Tuğlular 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. , Åsberg 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 İ. , 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. , Özyilmaz 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.
Журнал
Scientific Reports
Издательство
Nature Publishing Group
Номер выпуска
1
Язык
Английский
Статус
Опубликовано
Ссылка
Внешняя ссылка
DOI
10.1038/S41598-022-22657-4
Номер
17978
Том
12
Год
2022
Организации
  • 1 Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, Netherlands
  • 2 Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen, Netherlands
  • 3 Department of Nephrology, Radboud University Medical Center, Nijmegen, Netherlands
  • 4 Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
  • 5 Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
  • 6 Dr Ci Parhon Hospital, Iasi, Romania
  • 7 Helsinki University Central Hospital and Helsinki University, Helsinki, Finland
  • 8 Zuyderland Ziekenhuis, Sittard-Geleen, Netherlands
  • 9 Satakunta Central Hospital, Pori, Finland
  • 10 Tergooi Medical Center, Hilversum, Netherlands
  • 11 ERA Registry, Amsterdam UMC Location University of Amsterdam, Medical Informatics, Meibergdreef 9, Amsterdam, Netherlands
  • 12 Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, Netherlands
  • 13 Albert Schweitzer Hospital, Dordrecht, Netherlands
  • 14 Ambroise Pare Hospital, APHP Paris-Saclay University, Boulogne Billancourt, France
  • 15 Amphia Hospital, Breda, Netherlands
  • 16 Amsterdam UMC, Amsterdam, Netherlands
  • 17 Antwerp University Hospital, Antwerp, Belgium
  • 18 Faculty of Medicine, Avicennes Military Hospital, Cadi Ayyad University, Marrakech, Morocco
  • 19 AZ Delta, Roeselare, Belgium
  • 20 B. Braun Avitum, Litomerice, Czech Republic
  • 21 Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
  • 22 Bernhoven Hospital, Uden, Netherlands
  • 23 Bravis Hospital, Roosendaal/Bergen Op Zoom, Netherlands
  • 24 Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
  • 25 ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
  • 26 Emergency Clinical Hospital ‘Sf. Ioan’, Bucharest, Romania
  • 27 Catharina Hospital, Eindhoven, Netherlands
  • 28 Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
  • 29 Centre Hospitalier du Nord, Ettelbruck, Luxembourg
  • 30 Centre of Postgraduate Medical Education, Warsaw, Poland
  • 31 Centrodial, São João da Madeira, Portugal
  • 32 Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • 33 City Hospital N.a. S.P. Botkin, Moscow, Russian Federation
  • 34 City Hospital Zürich, Zurich, Switzerland
  • 35 Claude Galien Hospital Ramsay Santé, Quincy-Sous-Sénart, France
  • 36 Clínica de Hemodiálise de Felgueiras, Felgueiras, Portugal
  • 37 Clinical Centre of Vojvodina & Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
  • 38 Croatian Society of Nephrology, Dialysis and Transplantation, Zagreb, Croatia
  • 39 CWZ Nijmegen, Nijmegen, Netherlands
  • 40 DaVita Geilenkirchen, Geilenkirchen, Germany
  • 41 DaVita, Wrocław, Poland
  • 42 1St Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • 43 Deventer Ziekenhuis, Deventer, Netherlands
  • 44 Dianet Dialysis Center, Utrecht, Netherlands
  • 45 Dialysis Center Bochum, Bochum, Germany
  • 46 Dnipro State Medical University, Dnipro, Ukraine
  • 47 Elyse Klinieken Voor Nierzorg, Kerkrade, Netherlands
  • 48 Epidemiology Department, High Institute of Public Health-Alexandria University, Alexandria, Egypt
  • 49 Erasme Hospital, Brussels, Belgium
  • 50 Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
  • 51 Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
  • 52 Faculty of Medicine-Alexandria University, Alexandria, Egypt
  • 53 Franciscus Gasthuis & Vlietland, Schiedam, Netherlands
  • 54 Freeman Hospital, Newcastle Upon Tyne, United Kingdom
  • 55 Fundació Puigvert, Barcelona, Spain
  • 56 Fundación Jiménez Díaz, Madrid, Spain
  • 57 Gdansk Medical University, Gdansk, Poland
  • 58 Gelre Hospital, Apeldoorn, Netherlands
  • 59 General Hospital of Athens “G. Gennimatas”, Athens, Greece
  • 60 General Hospital of Serres, Serres, Greece
  • 61 General University Hospital of Alexandroupolis, Alexandroupolis, Greece
  • 62 Grande Ospedale Metropolitano and CNR, Reggio Calabria, Italy
  • 63 Haaglanden Medisch Centrum, The Hague, Netherlands
  • 64 Haga Hospital, The Hague, Netherlands
  • 65 Hospital Clínic de Barcelona, Barcelona, Spain
  • 66 Hospital Curry Cabral-Central Lisbon University Hospital Center, Lisbon, Portugal
  • 67 Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • 68 Hospital del Mar, Barcelona, Spain
  • 69 Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
  • 70 Hospital Gelderse Vallei, Ede, Netherlands
  • 71 Hospital General of Alicante, Alicante, Spain
  • 72 Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • 73 Hospital Obispo Polanco, Salud Aragón, Spain
  • 74 Hospital Universitario Ramón y Cajal, Madrid, Spain
  • 75 Imelda Hospital, Bonheiden, Belgium
  • 76 Isala, Zwolle, Netherlands
  • 77 Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  • 78 Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
  • 79 Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
  • 80 Leiden University Medical Center, Leiden, Netherlands
  • 81 Lister Hospital, Stevenage, United Kingdom
  • 82 Lithuanian University of Health Sciences, Kaunas, Lithuania
  • 83 Luzerner Kantonsspital, Luzern, Switzerland
  • 84 Maasstad Ziekenhuis, Rotterdam, Netherlands
  • 85 Maastricht University Medical Center, Maastricht, Netherlands
  • 86 Manipal Hospital, Manipal, India
  • 87 Marche Nord Hospital, Pesaro, Italy
  • 88 Marmara University School of Medicine, Istanbul, Turkey
  • 89 Martini Ziekenhuis, Groningen, Netherlands
  • 90 Maxima Medisch Centrum, Veldhoven, Netherlands
  • 91 Meander Medisch Centrum, Amersfoort, Netherlands
  • 92 Medical University Innsbruck, Innsbruck, Austria
  • 93 Medical University of Vienna, Vienna, Austria
  • 94 Moscow Regional Research and Clinical Institute, Moscow, Russian Federation
  • 95 Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
  • 96 Nephrology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
  • 97 Nierenzentrum Reutlingen-Tübingen, Reutlingen, Germany
  • 98 Norwegian Renal Registry, Oslo University Hospital–Rikshospitalet, Olso, Norway
  • 99 Okinawa Chubu Hospital, Uruma, Japan
  • 100 OLVG, Amsterdam, Netherlands
  • 101 Ospedale S. Maurizio Bolzano, Bolzano, Italy
  • 102 Padua University Hospital, Padua, Italy
  • 103 Radboud University Medical Center, Nijmegen, Netherlands
  • 104 Regional Clinical Hospital, Yaroslavl, Russian Federation
  • 105 Regional Hospital of Malaga, Malaga, Spain
  • 106 Rijnstate Hospital, Arnhem, Netherlands
  • 107 RUDN University, Moscow, Russian Federation
  • 108 Saint-Petersburg State University Hospital, Saint-Petersburg, Russian Federation
  • 109 San Marco Hospital, University of Catania, Catania, Italy
  • 110 Saxenburgh Medisch Centrum, Hardenberg, Netherlands
  • 111 Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
  • 112 Southern Health and Social Care Trust, Newry, United Kingdom
  • 113 Spaarne Gasthuis, Haarlem, Netherlands
  • 114 SPWSZ Hospital, Szczecinie, Poland
  • 115 St. Anna University Hospital, Ferrara, Italy
  • 116 St. Bassiano Hospital, Bassano del Grappo, Italy
  • 117 Streekziekenhuis Koningin Beatrix, Winterswijk, Netherlands
  • 118 Swedish Renal Registry, Jönköping, Sweden
  • 119 Tehran University of Medical Sciences, Tehran, Iran
  • 120 Third Faculty of Medicine, Charles University, and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
  • 121 Toledo University Hospital, Toledo, Spain
  • 122 Treant/Scheper Ziekenhuis, Emmen, Netherlands
  • 123 Turgut Ozal Medical Center, Malatya, Turkey
  • 124 Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium
  • 125 University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
  • 126 University Clinical Hospital of Valladolid, Valladolid, Spain
  • 127 Universitary Hospital of Guadalajara, Guadalajara, Spain
  • 128 University Hospital Leuven, Leuven, Belgium
  • 129 University Hospital Brussels, Brussels, Belgium
  • 130 University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia
  • 131 University Hospital Medical Center Verona, Verona, Italy
  • 132 University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
  • 133 University Hospital of Ioannina, Ioannina, Greece
  • 134 University Hospital of Patras, Patras, Greece
  • 135 University Medical Center Groningen, Groningen, Netherlands
  • 136 University Medical Center Ljubljana, Ljubljana, Slovenia
  • 137 University Medical Centre Maribor, Maribor, Slovenia
  • 138 University Medical Center Utrecht, Utrecht, Netherlands
  • 139 University of California Irvine School of Medicine, Orange, CA, United States
  • 140 University of Genoa, Genoa, Italy
  • 141 University of Liège, Liège, Belgium
  • 142 University of Milan, Milan, Italy
  • 143 University of Navarra Clinic, Pamplona, Spain
  • 144 University of Piemonte Orientale, Novara, Italy
  • 145 Valais Hospital, Sion & Lausanne University Hospital, Lausanne, Switzerland
  • 146 Vall d’Hebron University Hospital, Barcelona, Spain
  • 147 VieCuri Medical Centre, Venlo, Netherlands
  • 148 Vilnius University, Vilnius, Lithuania
  • 149 Vimercate Hospital, Vimercate, Italy
  • 150 Zonguldak Ataturk State Hospital, Zonguldak, Turkey
Ключевые слова
Aged; COVID-19; Female; Humans; Immunosuppressive Agents; Kidney; Kidney Transplantation; Male; Middle Aged; Renal Dialysis; Risk Factors; Sex Characteristics; immunosuppressive agent; adverse event; aged; female; hemodialysis; human; kidney; kidney transplantation; male; middle aged; risk factor; sexual characteristics
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McHedlova M.M., Guzelbaeva G.Ya.
Мониторинг общественного мнения: экономические и социальные перемены. Открытое акционерное общество Всероссийский центр изучения общественного мнения. 2022. С. 173-194