COVID-19 in Solid Organ Transplant Recipients: Observations From Connecticut

Kutzler, Heather L.; Poulos, Constantine M.; Cheema, Faiqa; O’Sullivan, David; Ali, Ayyaz; Ebcioglu, Zeynep; Einstein, Michael; Feingold, Andrew D.; Gluck, Jason; Hammond, Jonathan; Jaiswal, Abhishek; Lawlor, Michael; Morgan, G. W.; Radojevic, Joseph; Rochon, Caroline; Sheiner, Patricia A.; Singh, Joseph; Sotil, Eva U.; Swales, Colin; Ye, Xiaoyi; Serrano, Oscar K.

doi:10.1097/tp.0000000000003495

Cited by 8 publications

(9 citation statements)

References 3 publications

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“…In the solid organ transplant (SOT) recipient population, numerous studies have demonstrated that these patients are an exceptionally vulnerable population to developing severe manifestations of COVID-19 given their immunosuppressed state. [1][2][3][4][5] Severe manifestations may include a higher risk of hospitalization, intensive care unit stays and death compared to the general population. 1,5 COVID-19 directed treatments are limited.…”

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confidence: 99%

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Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients

Kutzler

Kuzaro

Serrano

et al. 2021

Transplant Infectious Dis

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The widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to propagate the coronavirus disease 2019 (COVID-19) pandemic with solid organ transplant (SOT) recipients being an exceptionally vulnerable population for poor outcomes. Treatments for COVID-19 are limited; however, monoclonal antibodies are emerging as a potential therapeutic option to change the trajectory of high-risk patients. This retrospective single center cohort study evaluated the outcomes of SOT recipients with mild to moderate COVID-19 who received bamlanivimab monotherapy. Eighteen SOT recipients (15 kidney, 2 liver, and 1 heart)

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confidence: 99%

“…[1][2][3][4][5] Severe manifestations may include a higher risk of hospitalization, intensive care unit stays and death compared to the general population. 1,5 COVID-19 directed treatments are limited. Currently, the antiviral agent remdesivir is the only US Food and Drug Administration (FDA)-approved therapeutic option for the treatment of COVID-19.…”

mentioning

confidence: 99%

Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients

Kutzler

Kuzaro

Serrano

et al. 2021

Transplant Infectious Dis

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“…In the case of duplicate publications, the most recent available data were considered and included in the analysis. After the resolution of differences between reviewers and removal of duplicate reports, all available observational retrospective studies and case series were selected for data extraction [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. This process identified 48 individual studies reporting a total of 3137 renal transplant patients with COVID-19 from 12 different countries located in North America, Europe, and Asia ( Table A1 , Table A2 and Table A3 ).…”

Section: Resultsmentioning

confidence: 99%

The Impact of COVID-19 on Kidney Transplant Recipients in Pre-Vaccination and Delta Strain Era: A Systematic Review and Meta-Analysis

Jayant

Reccia

Bachul

et al. 2021

JCM

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Herein, we performed a meta-analysis of published clinical outcomes of corona virus disease 2019 (COVID-19) in hospitalized kidney transplant recipients. A systematic database search was conducted between December 1, 2019 and April 20, 2020. We analyzed 48 studies comprising 3137 kidney transplant recipients with COVID-19. Fever (77%), cough (65%), dyspnea (48%), and gastrointestinal symptoms (28%) were predominant on hospital admission. The most common comorbidities were hypertension (83%), diabetes mellitus (34%), and cardiac disease (23%). The pooled prevalence of acute respiratory distress syndrome and acute kidney injury were 58% and 48%, respectively. Invasive ventilation and dialysis were required in 24% and 22% patients, respectively. In-hospital mortality rate was as high as 21%, and increased to over 50% for patients in intensive care unit (ICU) or requiring invasive ventilation. Risk of mortality in patients with acute respiratory distress syndrome (ARDS), on mechanical ventilation, and ICU admission was increased: OR = 19.59, OR = 3.80, and OR = 13.39, respectively. Mortality risk in the elderly was OR = 3.90; however, no such association was observed in terms of time since transplantation and gender. Fever, cough, dyspnea, and gastrointestinal symptoms were common on admission for COVID-19 in kidney transplant patients. Mortality was as high as 20% and increased to over 50% in patients in ICU and required invasive ventilation.

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“…Recipients of solid organ transplants are known to be vulnerable to viral infections secondary to a weakened T‐cell mediated immune response 86 . From 10 case reports 87–96 and 10 case series, 25,97–105 we identified 66 COVID‐19 patients who received a solid organ transplant and who were treated with convalescent plasma. Of these 66 patients, mortality was observed in nine patients (14%), 4 patients remain hospitalized at the end of the observation period, and 25 patients demonstrated rapid improvement in clinical symptomatology.…”

Section: Secondary Immunodeficiencymentioning

confidence: 99%

Use of convalescent plasma inCOVID‐19 patients with immunosuppression

et al. 2021

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In the absence of effective countermeasures, human convalescent plasma has been widely used to treat severe acute respiratory syndrome coronavirus 2, the causative agent of novel coronavirus disease 19 (COVID‐19), including among patients with innate or acquired immunosuppression. However, the association between COVID‐19‐associated mortality in patients with immunosuppression and therapeutic use of convalescent plasma is unknown. We review 75 reports, including one large matched‐control registry study of 143 COVID‐19 patients with hematological malignancies, and 51 case reports and 23 case series representing 238 COVID‐19 patients with immunosuppression. We review clinical features and treatment protocols of COVID‐19 patients with immunosuppression after treatment with human convalescent plasma. We also discuss the time course and clinical features of recovery. The available data from case reports and case series provide evidence suggesting a mortality benefit and rapid clinical improvement in patients with several forms of immunosuppression following COVID‐19 convalescent plasma transfusion. The utility of convalescent plasma or other forms of antibody therapy in immune‐deficient and immune‐suppressed patients with COVID‐19 warrants further investigation.

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COVID-19 in Solid Organ Transplant Recipients: Observations From Connecticut

Cited by 8 publications

References 3 publications

Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients

Initial experience of bamlanivimab monotherapy use in solid organ transplant recipients

The Impact of COVID-19 on Kidney Transplant Recipients in Pre-Vaccination and Delta Strain Era: A Systematic Review and Meta-Analysis

Use of convalescent plasma inCOVID‐19 patients with immunosuppression

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