Abstract: PO0771
What Do Data Tell Us About Patients Receiving Calcineurin Inhibitors (CNIs) and Contracting a Coronavirus
Session Information
- COVID-19: CKD and Transplant Patients
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Son, Jung Hoon, pulseData, New York, New York, United States
- Fielding, Ollie, pulseData, New York, New York, United States
- Wang, Xiaoyan, pulseData, New York, New York, United States
- Kipers, Chris, pulseData, New York, New York, United States
- Silberzweig, Jeffrey I., The Rogosin Institute, New York, New York, United States
- Liu, Frank, The Rogosin Institute, New York, New York, United States
Group or Team Name
- The PEAK team
Background
We hypothesized that patients taking CNIs, cyclosporine and tacrolimus would be less susceptible to coronavirus infections because of antiviral and anti-cytokine-storm effects and compared the occurrence of positive coronavirus test rates in a population receiving a CNI and non-CNI treatment population. This is of high importance as CNIs are being trialed as a treatment for severe acute respiratory syndrome coronavirus 2 (COVID-19) immune response (NCT04341038). Transplant nephrologists recommend continuing CNIs through the COVID-19 pandemic.
Methods
We analyzed longitudinal EHR system data from the The Rogosin Institute’s nephrology clinic to identify a population of 5,144 patients with a record of respiratory viral panel (RVP) testing for any coronavirus strain between December 2012 and May 2020. We identified 1,195 patients receiving cyclosporine or tacrolimus and compared positive test rates of any coronavirus stain in those receiving CNIs to those not receiving CNIs.
Results
A total of 51 patients tested positive (1.05%) Of the 1,195 CNI recipients, 21 tested positive (1.76%); of 3,949 patients with no record of CNI treatment, 33 tested positive (0.84%). Given an age distribution difference between the two cohorts (CNI cohort median 58; non-CNI cohort median 68). We therefore calculated an age-adjusted positive test rate for both populations, with results of 1.76% for the CNI cohort and 0.83% for the non-CNI cohort. A z-test comparing the population proportions testing positive had a z-value of 2.71 (p-value 0.003), indicating significant difference. 8.47% of positive tests on an RVP for any of coronavirus, rhinovirus or respiratory syncytial were for a coronavirus in the CNI group vs. 6.48% in the non-CNI group (z 2.37, p 0.009). Using a logistic regression model to examine the probability of testing positive for a coronavirus (features for age, gender, whether the test was conducted in flu season (Dec-Feb) and whether the patient was receiving CNIs) we found that CNIs were statistically significant (p 0.007).
Conclusion
Based on the data, as far as we can tell being on a CNI does not offer protection from a symptomatic coronavirus infection. It remains to be seen if it decreases severity of the illness because of the potential for cytokine storm effects.
Funding
- Commercial Support –