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Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy
Priya Vart1,2, Raphaël Duivenvoorden3, Aaltje Adema4
1Department Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. p.vart@umcg.nl.
Scientific Reports
|October 26, 2022
Summary
Male sex is not a mortality risk for kidney transplant recipients with COVID-19. However, male dialysis patients with COVID-19 face a higher mortality risk compared to females.
Area of Science:
- Nephrology
- Immunology
- Infectious Diseases
Background:
- Male sex is a known risk factor for COVID-19 mortality in the general population, linked to immune response differences.
- Patients on kidney function replacement therapy (KFRT), particularly kidney transplant recipients (KTRs) on immunosuppressants, exhibit impaired immune responses.
Purpose of the Study:
- To investigate if male sex remains a COVID-19 mortality risk factor in patients undergoing KFRT.
- To compare mortality risks between male and female KTRs and dialysis patients.
Main Methods:
- Analysis of the European Renal Association COVID-19 Database (ERACODA) for KFRT patients diagnosed between February 2020 and April 2021.
- Examined 1204 KTRs and 3206 dialysis patients, assessing three-month mortality rates.
- Utilized adjusted hazard ratios (aHR) to evaluate mortality risk factors, including sex and KFRT type.
Main Results:
- Among KTRs, three-month mortality showed no significant sex difference (16.9% males vs. 18.6% females, p=0.31).
- Dialysis patients exhibited higher mortality in males (27.1%) compared to females (21.9%, p=0.001).
- The adjusted hazard ratio for mortality was 0.89 for males vs. females in KTRs (p=0.49) and 1.33 in dialysis patients (p=0.001).
Conclusions:
- Male sex is not a significant mortality risk factor for kidney transplant recipients with COVID-19.
- Male sex remains a significant mortality risk factor for dialysis patients with COVID-19.
- Immunosuppression in KTRs may mitigate sex-based differences in immune response and COVID-19 mortality risk.
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