Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience

Akdur, Aydıncan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; AlShalabi, Omar; Kırnap, Mahir; Arslan, Hande; Ulubay, Gaye; Hekimoğlu, Koray; Moray, Gökhan; Haberal, Mehmet

doi:10.6002/ect.2020.0193

Cited by 37 publications

(48 citation statements)

References 12 publications

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“…senting with gastrointestinal symptoms exist, 20,31 this has not been consistently shown in other studies, where the presenting symptoms in SOT patients were similar to the general population. 18,22,32 Our findings are important, as diarrhea in SOT patients is common and can be multifactorial, related to medications or other viral infections.…”

Section: Ta B L Ementioning

confidence: 71%

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Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Molnar

Bhalla

Azhar

et al. 2020

American Journal of Transplantation

110

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National data on patient characteristics, treatment, and outcomes of critically ill coronavirus disease 2019 (COVID‐19) solid organ transplant (SOT) patients are limited. We analyzed data from a multicenter cohort study of adults with laboratory‐confirmed COVID‐19 admitted to intensive care units (ICUs) at 68 hospitals across the United States from March 4 to May 8, 2020. From 4153 patients, we created a propensity score matched cohort of 386 patients, including 98 SOT patients and 288 non‐SOT patients. We used a binomial generalized linear model (log‐binomial model) to examine the association of SOT status with death and other clinical outcomes. Among the 386 patients, the median age was 60 years, 72% were male, and 41% were black. Death within 28 days of ICU admission was similar in SOT and non‐SOT patients (40% and 43%, respectively; relative risk [RR] 0.92; 95% confidence interval [CI]: 0.70‐1.22). Other outcomes and requirement for organ support including receipt of mechanical ventilation, development of acute respiratory distress syndrome, and receipt of vasopressors were also similar between groups. There was a trend toward higher risk of acute kidney injury requiring renal replacement therapy in SOT vs. non‐SOT patients (37% vs. 27%; RR [95% CI]: 1.34 [0.97‐1.85]). Death and organ support requirement were similar between SOT and non‐SOT critically ill patients with COVID‐19.

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Section: Ta B L Ementioning

confidence: 71%

“…ARDS/respiratory failure 39 (29) 13 (30) Heart failure 5 (4) 1 (2) Septic shock 16 (12) 10 23Kidney failure 42 (32) 13 (30) Liver failure 10 (8) 2 (5)…”

Section: Primary Outcomesmentioning

confidence: 99%

Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Molnar

Bhalla

Azhar

et al. 2020

American Journal of Transplantation

110

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“…Hydroxychloroquine sulfate and chloroquine phosphate, historically, anti-malaria drugs, have also been investigated for treatment of COVID-19 in clinical trials. 64,65 In the current study, hydroxychloroquine was used in 54.8% (121/221) of KTx patients, most frequently in those with severe symptomatology [18][19][20][21]24,27,28,[30][31][32]34,[36][37][38][39][40][41][43][44][45][46][47][48]51 , and umifenovir, alone or in combination. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41]…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 76%

“…Some discrepancies between Xray and CT scan findings were noted in few patients (negative Xraypositive CT scan). among studies, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] 97.2% of patients received broad spectrum antibiotics empirically.…”

Section: Symptomatology and Laboratory Findingsmentioning

confidence: 99%

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Moris

Kesseli

Barbas

2020

Transplant Infectious Dis

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There is an accumulating body of literature surrounding the impact of COVID‐19 infection in solid organ transplant recipients. The aim of this review is to summarize the existing literature specifically in kidney transplant (KTx) recipients, with an emphasis on the epidemiology, clinical presentation, laboratory findings, post‐operative outcomes and therapeutic strategies currently employed. We identified thirty‐seven studies published between January 1 st 2020 to June 10 th 2020 that were included in our analysis. As is reported in the general population, there is a wide variation in COVID‐19 presentation among KTx patients, ranging from asymptomatic to life‐threatening end‐organ failure. The most common symptoms are predominantly respiratory and associated with fever. On lab evaluation, many patients present with lymphopenia and increased CRP, which are both associated with inferior outcomes. The majority of patients with severe symptoms have been managed with reduction of immunosuppression, including decreased doses of CNIs and withdrawal of MMF. Lastly, although there is no high‐level data supporting the use of immunomodulatory drugs, such as IL‐6 inhibitors, early experiences have suggested these drugs may improve outcomes in KTx patients with severe COVID‐19.

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“…This mandates caution and candidates for transplantation are delayed if their condition allows to. However, countries where social distancing measures have been in place for as long as the median virus incubation time, have the opportunity to rule out possible false negative tests from recipients who have complied with the social restriction policy [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Transplantation during the COVID-19 pandemic: nothing noble is accomplished without danger

et al. 2020

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The global health crisis due to the fast spread of coronavirus disease (COVID-19) has caused major disruption in all aspects of healthcare. Transplantation is one of the most affected sectors, as it relies on a variety of services that have been drastically occupied to treat patients affected by COVID-19. With this report from two transplant centers in Italy, we aim to reflect on resource organization, organ allocation, virus testing and transplant service provision during the course of the pandemic and to provide actionable information highlighting advantages and drawbacks. To what extent can we preserve the noble purpose of transplantation in times of increased danger? Strategies to minimize risk exposure to the transplant population and health-workers include systematic virus screening, protection devices, social distancing and reduction of patients visits to the transplant center. While resources for the transplant activity are inevitably reduced, new dilemmas arise to the transplant community: further optimization of time constraints during organ retrievals and implantation, less organs and blood products donated, limited space in the intensive care unit and the duty to maintain safety and outcomes.

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Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience

Cited by 37 publications

References 12 publications

Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Transplantation during the COVID-19 pandemic: nothing noble is accomplished without danger

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