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07.07.2022 | original article

Association of the novel CROW-65 risk score and mortality in hospitalized kidney transplant recipients with COVID-19

A retrospective observational study

verfasst von: Josipa Domjanović, MD Andrija Matetic, Darija Baković Kramarić, Tea Domjanović Škopinić, Dijana Borić Škaro, Nikola Delić, Frane Runjić, Ivo Jeličić

Erschienen in: Wiener klinische Wochenschrift

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Summary

Background

Kidney transplant recipients (KTR) are a group of patients with heterogeneous risks for adverse outcomes with COVID-19, but risk stratification tools in this patient group are lacking.

Methods and participants

This retrospective observational, hypothesis-generating study included 49 hospitalized adult KTR patients with COVID-19 at the University Hospital of Split (August 2020 to October 2021) and evaluated the performance of novel risk score CROW-65 (age, Charlson Comorbidity Index [CCI] lactate dehydrogenase to white blood cell [LDH:WBC] ratio, and respiratory rate oxygenation [ROX index]). The primary outcome of the study was 30-day postdischarge all-cause mortality.

Results

A total of 8 fatal events (16.3%) occurred during the study follow-up. When comparing CROW-65 by survival status, it was significantly increased in patients with fatal event (P < 0.001). Using the Cox proportional hazards regression analysis, the CROW-65 risk score showed statistically significant association with mortality (HR 1.11, 95% CI 1.01–1.23, P = 0.027), while receiving operator characteristics (ROC) showed significant discrimination of all-cause mortality with an AUC of 0.85 (95% CI 0.72–0.94, P < 0.001), and satisfactory calibration (χ2 4.91, P = 0.555 and Harrell’s C 0.835). Finally, survival Kaplan-Meier analysis confirmed significantly higher cumulative incidence of mortality with increasing risk score tertiles and curve separation after 13 days (P = 0.009).

Conclusion

A novel risk score CROW-65 showed significant association with all-cause mortality in KTR yielding important hypothesis-generating findings. Further powered studies should reassess the performance of CROW-65 risk score in this population, including predictability, calibration and discrimination.
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Metadaten
Titel
Association of the novel CROW-65 risk score and mortality in hospitalized kidney transplant recipients with COVID-19
A retrospective observational study
verfasst von
Josipa Domjanović
MD Andrija Matetic
Darija Baković Kramarić
Tea Domjanović Škopinić
Dijana Borić Škaro
Nikola Delić
Frane Runjić
Ivo Jeličić
Publikationsdatum
07.07.2022
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-022-02052-9