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Sex Differences in Covid-19 Mortality Risk in Patients on Kidney Function Replacement Therapy Publisher Pubmed



Vart P1, 2 ; Duivenvoorden R3 ; Adema A4 ; Covic A5, 6 ; Finne P7 ; Braak NHT8 ; Laine K9 ; Noordzij M1 ; Schouten M10 ; Jager KJ11, 12 ; Gansevoort RT1 ; Van Der Net JB13 ; Essig M14 ; Du Bufvereijken PWG15 Show All Authors
Authors
  1. Vart P1, 2
  2. Duivenvoorden R3
  3. Adema A4
  4. Covic A5, 6
  5. Finne P7
  6. Braak NHT8
  7. Laine K9
  8. Noordzij M1
  9. Schouten M10
  10. Jager KJ11, 12
  11. Gansevoort RT1
  12. Van Der Net JB13
  13. Essig M14
  14. Du Bufvereijken PWG15
  15. Van Ginneken B15
  16. Maas N15
  17. Van Jaarsveld BC16
  18. Bemelman FJ16
  19. Klingenbergsalahova F16
  20. Heenanvos F16
  21. Vervloet MG16
  22. Nurmohamed A16
  23. Vogt L16
  24. Abramowicz D17
  25. Verhofstede S17
  26. Maoujoud O18
  27. Malfait T19
  28. Fialova J20
  29. Melilli E21
  30. Fava A21
  31. Cruzado JM21
  32. Perez NM21
  33. Lips J22
  34. Krepel H23
  35. Adilovic H24
  36. Radulescu D25, 26
  37. Hengst M27
  38. Konings C27
  39. Rydzewski A28
  40. Braconnier P29
  41. Weis D29
  42. Gellert R30
  43. Oliveira J31
  44. Alferes DG32
  45. Zakharova EV33
  46. Ambuhl PM34
  47. Guidotti R34
  48. Walker A34
  49. Lepeytre F35
  50. Rabate C35
  51. Rostoker G35
  52. Marques S36
  53. Azasevac T37
  54. Majstorovic GS37
  55. Katicic D38
  56. Ten Dam M39
  57. Kruger T40
  58. Brzosko S41
  59. Liakopoulos V42
  60. Zanen AL43
  61. Logtenberg SJJ44
  62. Fricke L45
  63. Kuryata O46
  64. Slebe JJP47
  65. Elhafeez SA48
  66. Kemlin D49
  67. Van De Wetering J50
  68. Reinders MEJ50
  69. Hesselink DA50
  70. Kalvan Gestel J50
  71. Eiselt J51
  72. Kielberger L51
  73. Elwakil HS52
  74. Verhoeven M53
  75. Logan I54
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  77. Facundo C55
  78. Ramos AM56
  79. Debskaslizien A57
  80. Veldhuizen NMH58
  81. Tigka E59
  82. Konsta MAP60
  83. Panagoutsos S61
  84. Mallamaci F62
  85. Postorino A62
  86. Cambareri F62
  87. Matceac I5, 6
  88. Nistor I5, 6
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  94. Blasco M65
  95. Pereira TA66
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  102. Jimenez MDA68
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  122. Safak S77
  123. Hollander DAMJ78
  124. Buttner S79
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  129. Bouwsma H80
  130. Sridharan S81
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  132. Maloney SR83
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  143. Kerschbaum J92
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  148. Turkmen K95
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  151. Fliedner A97
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  154. Miyasato H99
  155. De Fijter CWH100
  156. Mongera N101
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  159. Kerckhoffs A103
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  167. Titov D107
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  171. Van Kempen G110
  172. Van Gilsverrij LEA111
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  174. Meurs M113
  175. Myslak M114
  176. Battaglia Y115
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  179. Stendahl M118
  180. Rahimzadeh H119
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  192. De Arriba G127
  193. Meijers BKI128
  194. Naesens M128
  195. Kuypers D128
  196. Desschans B128
  197. Tonnerlier A129
  198. Wissing KM129
  199. Dedinska I130
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  204. Berger SP135
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  213. Abrahams AC138
  214. Molenaar FM138
  215. Van Zuilen AD138
  216. Meijvis SCA138
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  218. Tantisattamo E139
  219. Esposito P140
  220. Krzesinski JM141
  221. Barahira JD141
  222. Gallieni M142
  223. Martinmoreno PL143
  224. Guglielmetti G144
  225. Guzzo G145
  226. Toapanta N146
  227. Soler MJ146
  228. Luik AJ147
  229. Van Kuijk WHM147
  230. Stikkelbroeck LWH147
  231. Hermans MMH147
  232. Rimsevicius L148
  233. Righetti M149
  234. Islam M150
Show Affiliations
Authors Affiliations
  1. 1. Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, Netherlands
  2. 2. Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen, Netherlands
  3. 3. Department of Nephrology, Radboud University Medical Center, Nijmegen, Netherlands
  4. 4. Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
  5. 5. Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania
  6. 6. Dr Ci Parhon Hospital, Iasi, Romania
  7. 7. Helsinki University Central Hospital and Helsinki University, Helsinki, Finland
  8. 8. Zuyderland Ziekenhuis, Sittard-Geleen, Netherlands
  9. 9. Satakunta Central Hospital, Pori, Finland
  10. 10. Tergooi Medical Center, Hilversum, Netherlands
  11. 11. ERA Registry, Amsterdam UMC Location University of Amsterdam, Medical Informatics, Meibergdreef 9, Amsterdam, Netherlands
  12. 12. Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, Netherlands
  13. 13. Albert Schweitzer Hospital, Dordrecht, Netherlands
  14. 14. Ambroise Pare Hospital, APHP Paris-Saclay University, Boulogne Billancourt, France
  15. 15. Amphia Hospital, Breda, Netherlands
  16. 16. Amsterdam UMC, Amsterdam, Netherlands
  17. 17. Antwerp University Hospital, Antwerp, Belgium
  18. 18. Faculty of Medicine, Avicennes Military Hospital, Cadi Ayyad University, Marrakech, Morocco
  19. 19. AZ Delta, Roeselare, Belgium
  20. 20. B. Braun Avitum, Litomerice, Czech Republic
  21. 21. Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
  22. 22. Bernhoven Hospital, Uden, Netherlands
  23. 23. Bravis Hospital, Roosendaal/Bergen Op Zoom, Netherlands
  24. 24. Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
  25. 25. ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
  26. 26. Emergency Clinical Hospital ‘Sf. Ioan’, Bucharest, Romania
  27. 27. Catharina Hospital, Eindhoven, Netherlands
  28. 28. Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
  29. 29. Centre Hospitalier du Nord, Ettelbruck, Luxembourg
  30. 30. Centre of Postgraduate Medical Education, Warsaw, Poland
  31. 31. Centrodial, Sao Joao da Madeira, Portugal
  32. 32. Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  33. 33. City Hospital N.a. S.P. Botkin, Moscow, Russian Federation
  34. 34. City Hospital Zurich, Zurich, Switzerland
  35. 35. Claude Galien Hospital Ramsay Sante, Quincy-Sous-Senart, France
  36. 36. Clinica de Hemodialise de Felgueiras, Felgueiras, Portugal
  37. 37. Clinical Centre of Vojvodina & Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia
  38. 38. Croatian Society of Nephrology, Dialysis and Transplantation, Zagreb, Croatia
  39. 39. CWZ Nijmegen, Nijmegen, Netherlands
  40. 40. DaVita Geilenkirchen, Geilenkirchen, Germany
  41. 41. DaVita, Wroclaw, Poland
  42. 42. 1St Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  43. 43. Deventer Ziekenhuis, Deventer, Netherlands
  44. 44. Dianet Dialysis Center, Utrecht, Netherlands
  45. 45. Dialysis Center Bochum, Bochum, Germany
  46. 46. Dnipro State Medical University, Dnipro, Ukraine
  47. 47. Elyse Klinieken Voor Nierzorg, Kerkrade, Netherlands
  48. 48. Epidemiology Department, High Institute of Public Health-Alexandria University, Alexandria, Egypt
  49. 49. Erasme Hospital, Brussels, Belgium
  50. 50. Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
  51. 51. Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
  52. 52. Faculty of Medicine-Alexandria University, Alexandria, Egypt
  53. 53. Franciscus Gasthuis & Vlietland, Schiedam, Netherlands
  54. 54. Freeman Hospital, Newcastle Upon Tyne, United Kingdom
  55. 55. Fundacio Puigvert, Barcelona, Spain
  56. 56. Fundacion Jimenez Diaz, Madrid, Spain
  57. 57. Gdansk Medical University, Gdansk, Poland
  58. 58. Gelre Hospital, Apeldoorn, Netherlands
  59. 59. General Hospital of Athens “G. Gennimatas�, Athens, Greece
  60. 60. General Hospital of Serres, Serres, Greece
  61. 61. General University Hospital of Alexandroupolis, Alexandroupolis, Greece
  62. 62. Grande Ospedale Metropolitano and CNR, Reggio Calabria, Italy
  63. 63. Haaglanden Medisch Centrum, The Hague, Netherlands
  64. 64. Haga Hospital, The Hague, Netherlands
  65. 65. Hospital Clinic de Barcelona, Barcelona, Spain
  66. 66. Hospital Curry Cabral-Central Lisbon University Hospital Center, Lisbon, Portugal
  67. 67. Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  68. 68. Hospital del Mar, Barcelona, Spain
  69. 69. Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
  70. 70. Hospital Gelderse Vallei, Ede, Netherlands
  71. 71. Hospital General of Alicante, Alicante, Spain
  72. 72. Hospital General Universitario Gregorio Maranon, Madrid, Spain
  73. 73. Hospital Obispo Polanco, Salud Aragon, Spain
  74. 74. Hospital Universitario Ramon y Cajal, Madrid, Spain
  75. 75. Imelda Hospital, Bonheiden, Belgium
  76. 76. Isala, Zwolle, Netherlands
  77. 77. Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  78. 78. Jeroen Bosch Ziekenhuis, Den Bosch, Netherlands
  79. 79. Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
  80. 80. Leiden University Medical Center, Leiden, Netherlands
  81. 81. Lister Hospital, Stevenage, United Kingdom
  82. 82. Lithuanian University of Health Sciences, Kaunas, Lithuania
  83. 83. Luzerner Kantonsspital, Luzern, Switzerland
  84. 84. Maasstad Ziekenhuis, Rotterdam, Netherlands
  85. 85. Maastricht University Medical Center, Maastricht, Netherlands
  86. 86. Manipal Hospital, Manipal, India
  87. 87. Marche Nord Hospital, Pesaro, Italy
  88. 88. Marmara University School of Medicine, Istanbul, Turkey
  89. 89. Martini Ziekenhuis, Groningen, Netherlands
  90. 90. Maxima Medisch Centrum, Veldhoven, Netherlands
  91. 91. Meander Medisch Centrum, Amersfoort, Netherlands
  92. 92. Medical University Innsbruck, Innsbruck, Austria
  93. 93. Medical University of Vienna, Vienna, Austria
  94. 94. Moscow Regional Research and Clinical Institute, Moscow, Russian Federation
  95. 95. Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
  96. 96. Nephrology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
  97. 97. Nierenzentrum Reutlingen-Tubingen, Reutlingen, Germany
  98. 98. Norwegian Renal Registry, Oslo University Hospital–Rikshospitalet, Olso, Norway
  99. 99. Okinawa Chubu Hospital, Uruma, Japan
  100. 100. OLVG, Amsterdam, Netherlands
  101. 101. Ospedale S. Maurizio Bolzano, Bolzano, Italy
  102. 102. Padua University Hospital, Padua, Italy
  103. 103. Radboud University Medical Center, Nijmegen, Netherlands
  104. 104. Regional Clinical Hospital, Yaroslavl, Russian Federation
  105. 105. Regional Hospital of Malaga, Malaga, Spain
  106. 106. Rijnstate Hospital, Arnhem, Netherlands
  107. 107. RUDN University, Moscow, Russian Federation
  108. 108. Saint-Petersburg State University Hospital, Saint-Petersburg, Russian Federation
  109. 109. San Marco Hospital, University of Catania, Catania, Italy
  110. 110. Saxenburgh Medisch Centrum, Hardenberg, Netherlands
  111. 111. Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
  112. 112. Southern Health and Social Care Trust, Newry, United Kingdom
  113. 113. Spaarne Gasthuis, Haarlem, Netherlands
  114. 114. SPWSZ Hospital, Szczecinie, Poland
  115. 115. St. Anna University Hospital, Ferrara, Italy
  116. 116. St. Bassiano Hospital, Bassano del Grappo, Italy
  117. 117. Streekziekenhuis Koningin Beatrix, Winterswijk, Netherlands
  118. 118. Swedish Renal Registry, Jonkoping, Sweden
  119. 119. Tehran University of Medical Sciences, Tehran, Iran
  120. 120. Third Faculty of Medicine, Charles University, and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
  121. 121. Toledo University Hospital, Toledo, Spain
  122. 122. Treant/Scheper Ziekenhuis, Emmen, Netherlands
  123. 123. Turgut Ozal Medical Center, Malatya, Turkey
  124. 124. Universite Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium
  125. 125. University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
  126. 126. University Clinical Hospital of Valladolid, Valladolid, Spain
  127. 127. Universitary Hospital of Guadalajara, Guadalajara, Spain
  128. 128. University Hospital Leuven, Leuven, Belgium
  129. 129. University Hospital Brussels, Brussels, Belgium
  130. 130. University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia
  131. 131. University Hospital Medical Center Verona, Verona, Italy
  132. 132. University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
  133. 133. University Hospital of Ioannina, Ioannina, Greece
  134. 134. University Hospital of Patras, Patras, Greece
  135. 135. University Medical Center Groningen, Groningen, Netherlands
  136. 136. University Medical Center Ljubljana, Ljubljana, Slovenia
  137. 137. University Medical Centre Maribor, Maribor, Slovenia
  138. 138. University Medical Center Utrecht, Utrecht, Netherlands
  139. 139. University of California Irvine School of Medicine, Orange, CA, United States
  140. 140. University of Genoa, Genoa, Italy
  141. 141. University of Liege, Liege, Belgium
  142. 142. University of Milan, Milan, Italy
  143. 143. University of Navarra Clinic, Pamplona, Spain
  144. 144. University of Piemonte Orientale, Novara, Italy
  145. 145. Valais Hospital, Sion & Lausanne University Hospital, Lausanne, Switzerland
  146. 146. Vall d’Hebron University Hospital, Barcelona, Spain
  147. 147. VieCuri Medical Centre, Venlo, Netherlands
  148. 148. Vilnius University, Vilnius, Lithuania
  149. 149. Vimercate Hospital, Vimercate, Italy
  150. 150. Zonguldak Ataturk State Hospital, Zonguldak, Turkey

Source: Scientific Reports Published:2022


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. © 2022, The Author(s).