Registry reports in COVID-19 patients: juggling with big data, poor data, and no data

To the editor:

We read with great interest the recent paper by Caillard et al.,¹ which is an interesting addition to the burgeoning coronavirus disease 2019 (COVID-19) literature.² However, we noted a discrepancy between the 426 kidney transplant recipients reported to the registry and the 279 cases presented, which corresponds to one-third of all patients. These available but unreported cases may have significantly impacted the results, but the authors neither explain this omission nor acknowledge it as a limitation. In addition, the authors’ choice of the term “severe” to collectively describe a broad group of patients requiring admission to the intensive care unit, patients requiring mechanical ventilation, as well as deceased patients would be considered a methodological error by intensivists. It would have been more appropriate to stratify the patients according to more detailed, objective criteria.³ These flaws likely stem from the limitations of registries, which are often based on voluntary contributions and frequently lack auditing procedures and links to governmental, automatic databases.

Although patient registries are essential instruments for medical community, their value during challenging times may be questionable as data are rapidly evolving, and individuals tasked with collecting and reporting data are overwhelmed by their daily clinical duties. In these rapidly shifting times, we urge the editors to weigh the temptation of registry studies against their relevance, completeness, and quality. Smaller single-center or multicenter studies with targeted data collection may be better suited to answer a specific research question and should not be undervalued because of their lower statistical power.