Racial/Ethnic Differences in Risk Factors Associated With Severe COVID-19 Among Older Adults With ADRD

Disparities in COVID-19-Related Mortality Among Older Adults With Alzheimer's Disease and Related Dementias: Variations Over Time

Older adults with Alzheimer's disease and related dementias (ADRD) had a high risk of COVID-19-related mortality. Racial and ethnic minorities were disproportionally impacted by the pandemic. The variations in disparities, including racial and ethnic disparities and disparities across communities, in COVID-19-related mortality across the different stages of the COVID-19 pandemic among the ADRD population are unknown. This observational study estimated linear probability models for community-dwelling older adults with ADRD who were diagnosed with COVID-19 in 2020 and 2021 using multiple national data (e.g., Medicare data), accounting for individual and community characteristics. Disparities in 30-day mortality were compared between 2020 and 2021. The socioeconomic disparity in COVID-19-related mortality across communities became insignificant during the later stage of the pandemic, ethnic differences in COVID-19-related mortality decreased but persisted, and racial disparity remained largely unchanged. The study provides insights into interventions to mitigate lingering disparities in health outcomes among the vulnerable population.

Risks of infection and severity of coronavirus disease 2019 in kidney transplant recipients: A single-center cohort study

BACKGROUND

The severity of coronavirus disease 2019 (COVID-19) is known to be high in kidney transplant recipients; however, the risk factors for COVID-19 infection in these patients has not been studied extensively. Therefore, we explored the predictors of COVID-19 infection and severity in kidney transplant recipients in Japan.

METHODS

This study included kidney transplant recipients who were regularly followed-up at our hospital from February 2021 to March 2023. We retrospectively reviewed the patients' medical charts; obtained their clinical information, including comorbidities, immunosuppressant usage, and presence of COVID-19 infection; and assessed the risk of COVID-19 infection and severity. Severe illness was defined as a decrease in oxygen saturation.

RESULTS

Among the 155 patients, 50 (32.3%) were infected with COVID-19. Multivariate analysis revealed that recipients taking >5 mg of prednisolone or taking tacrolimus instead of cyclosporine were at higher risk of infection (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.01-5.40; OR 2.29, 95% CI 1.03-5.07, respectively). Furthermore, of the 50 infected recipients, 42 had minor illness and eight had severe illness. Multivariate analysis revealed that recipients taking >5 mg of prednisolone were at a higher risk of severity (OR, 11.60, 95% CI 1.19-113.00).

CONCLUSION

In kidney transplant recipients, the infection rate and severity of COVID-19 tended to increase with higher maintenance doses of steroids. Recipients taking >5 mg of prednisolone should be considered a switch from tacrolimus to cyclosporine because cyclosporine may inhibit viral replication and reduce the risk of infection.