Abstract：
BACKGROUND: While coronavirus disease 2019 (COVID-19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic.
METHODS: Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID-19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID-19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT.
RESULTS: A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID-19-associated outcomes over time. In both non-SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID-19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group.
CONCLUSIONS: Our study provides a longitudinal view of the risks associated with adverse COVID-related outcomes amongst SOT and non-SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high-risk patients.
METHODS: Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID-19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID-19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT.
RESULTS: A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID-19-associated outcomes over time. In both non-SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID-19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group.
CONCLUSIONS: Our study provides a longitudinal view of the risks associated with adverse COVID-related outcomes amongst SOT and non-SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high-risk patients.
摘要：
背景：虽然2019年冠状病毒病（COVID-19）不再是公共卫生紧急情况，某些患者仍有严重结局的风险.为了更好地了解不断变化的风险状况，我们通过大流行的各种浪潮研究了有和没有实体器官移植（SOT）的患者的危险因素。
方法：使用国家COVID队列合作，我们研究了2020年1月1日至2022年5月2日期间COVID-19检测呈阳性的成年患者队列。我们将数据分成疾病控制中心定义的COVID-19波。在我们的主要结果中，我们使用多变量生存分析来观察有和无SOT患者住院的各种危险因素.
结果：共捕获3,570,032名患者。我们发现，随着时间的推移，COVID-19相关不良结局的总体风险减弱。在非SOT和SOT群体中，糖尿病,慢性肾病,充血性心力衰竭是住院的危险因素。特别是对于SOT，移植和COVID-19之间的较长时间段是保护性的，年龄是一个危险因素。值得注意的是,哮喘不是主要不良肾脏心血管事件的危险因素,住院治疗,或任何一组的死亡率。
结论：我们的研究提供了SOT和非SOT患者与COVID相关不良结局相关风险的纵向视图，以及这些风险因素如何随着时间的推移而演变。我们的工作将有助于告知提供者和政策制定者更好地针对高风险患者。
方法：使用国家COVID队列合作，我们研究了2020年1月1日至2022年5月2日期间COVID-19检测呈阳性的成年患者队列。我们将数据分成疾病控制中心定义的COVID-19波。在我们的主要结果中，我们使用多变量生存分析来观察有和无SOT患者住院的各种危险因素.
结果：共捕获3,570,032名患者。我们发现，随着时间的推移，COVID-19相关不良结局的总体风险减弱。在非SOT和SOT群体中，糖尿病,慢性肾病,充血性心力衰竭是住院的危险因素。特别是对于SOT，移植和COVID-19之间的较长时间段是保护性的，年龄是一个危险因素。值得注意的是,哮喘不是主要不良肾脏心血管事件的危险因素,住院治疗,或任何一组的死亡率。
结论：我们的研究提供了SOT和非SOT患者与COVID相关不良结局相关风险的纵向视图，以及这些风险因素如何随着时间的推移而演变。我们的工作将有助于告知提供者和政策制定者更好地针对高风险患者。
