First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study

Tschopp, Jonathan; L'Huillier, Arnaud G; Mombelli, Matteo; Mueller, Nicolas J.; Khanna, Nina; Garzoni, Christian; Meloni, Dario; Papadimitriou-Olivgeris, Matthaios; Neofytos, Dionysios; Hirsch, Hans H.; Schuurmans, Macé M.; Müller, Thomas; Berney, Thierry; Steiger, Jürg; Pascual, Manuel; Manuel, Oriol; Delden, Christian van

doi:10.1111/ajt.16062

Cited by 104 publications

(128 citation statements)

References 23 publications

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“…In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/ findings and content of this article. [50] S w i t z e r l a n d 5 0 Bhoori et al [39] I t a l y 6 3 ( 5 0 % )…”

Section: Compliance With Ethical Standardsmentioning

confidence: 99%

Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

Baryah

Midha

Mahajan

et al. 2020

Indian J Gastroenterol

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Worldwide, several hospitals in different regions and countries have been affected with Corona Virus Disease-19 (COVID-19). All medical specialties including gastroenterology are impacted by COVID-19. Here, we review the bidirectional comorbidity of chronic gastrointestinal (GI) disorders and COVID-19, including the incidence and outcome of COVID-19 in individuals with various GI disorders and the impact of COVID-19 on the course and outcome of the underlying (or comorbid) GI disorders. Currently, there is no evidence that COVID-19 is more (or less) frequent in comorbid GI disorders. It is also reassuring that the outcome of COVID-19 is unaffected by the underlying GI disorder or its treatment, though potential concerns remain in regard to the use of immunomodulatory treatments in inflammatory bowel disease (IBD) and liver transplant recipients. Despite these concerns, there is now agreement among experts that ongoing immunomodulatory treatments may not be interrupted in individuals with IBD during the COVID-19 pandemic. Caution, however, may be exercised with the use of corticosteroids in the management of IBD. In addition, COVID-19 does not appear to impact the manifestations, course, outcome, and treatment of comorbid GI disorders, e.g. IBD. Decompensation of liver cirrhosis is, however, possible during COVID-19 episodes. A direct concern, however, might relate to the potential transmission of the virus through fecal microbiota transplants.

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Section: Compliance With Ethical Standardsmentioning

confidence: 99%

Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

Baryah

Midha

Mahajan

et al. 2020

Indian J Gastroenterol

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“…Single‐center or regional experiences describing COVID‐19 mortality rates in transplant recipients have been published 6-15 . While such reports provide a limited assessment of the impact of COVID‐19 on SOT recipients, inclusion of a large “at risk” population with a high degree of data completeness is essential to more accurately quantify risk.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study

Ravanan

Callaghan

Mumford

et al. 2020

American Journal of Transplantation

131

164

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Patients waitlisted for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by linkage of the UK transplant registry and Public Health England and NHS Digital Tracing services, we examined the incidence of laboratory‐confirmed SARS‐CoV‐2 infection and subsequent mortality in patients on the active waiting list for a deceased donor SOT and recipients with a functioning SOT as of February 1, 2020 with follow‐up to May 20, 2020. Univariate and multivariable techniques were used to compare differences between groups and to control for case‐mix. One hundred ninety‐seven (3.8%) of the 5184 waitlisted patients and 597 (1.3%) of the 46 789 SOT recipients tested positive for SARS‐CoV‐2. Mortality after testing positive for SARS‐CoV‐2 was 10.2% (20/197) for waitlisted patients and 25.8% (154/597) for SOT recipients. Increasing recipient age was the only variable independently associated with death after positive SARS‐CoV‐2 test. Of the 1004 transplants performed in 2020, 41 (4.1%) recipients have tested positive for SARS‐CoV‐2 with 8 (0.8%) deaths reported by May 20. These data provide evidence to support decisions on the risks and benefits of SOT during the coronavirus disease 2019 pandemic.

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“…Mortality across kidney transplant recipients with COVID‐19 is still unclear. Although some US studies reported high mortality rates (about 20%‐30%), 3,4 a European study showed a reduced mortality in transplanted patients with COVID‐19 compared to the general population (9.5% vs 12.5%, respectively) 5 . Because of the possibility that immunosuppression may inhibit development of protective anti‐COVID‐19 immunity, many centers empirically reduce antirejection immunosuppression upon hospital admission for COVID‐19 infection.…”

Section: Introductionmentioning

confidence: 99%

Evidence of potent humoral immune activity in COVID-19-infected kidney transplant recipients

Hartzell

Bin

Benedetti

et al. 2020

American Journal of Transplantation

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Whether kidney transplant recipients are capable of mounting an effective anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) adaptive immune response despite chronic immunosuppression is unknown and has important implications for therapy. Herein, we analyzed peripheral blood cell surface and intracellular cytokine phenotyping by flow cytometry along with serum antibody testing in 18 kidney transplant recipients with active coronavirus disease 2019 (COVID‐19) infection and 36 matched, transplanted controls without COVID‐19. We observed significantly fewer total lymphocytes and fewer circulating memory CD4+ and CD8+ T cells in the COVID‐19 subjects. We also showed fewer anergic and senescent CD8+ T cells in COVID‐19 individuals, but no differences in exhausted CD8+ T cells, nor in any of these CD4+ T cell subsets between groups. We also observed greater frequencies of activated B cells in the COVID‐19 patients. Sixteen of 18 COVID‐19 subjects tested for anti‐SARS‐CoV‐2 serum antibodies showed positive immunoglobulin M or immunoglobulin G titers. Additional analyses showed no significant correlation among immune phenotypes and degrees of COVID‐19 disease severity. Our findings indicate that immunosuppressed kidney transplant recipients admitted to the hospital with acute COVID‐19 infection can mount SARS‐CoV‐2‐reactive adaptive immune responses. The findings raise the possibility that empiric reductions in immunosuppressive therapy for all kidney transplant recipients with active COVID‐19 may not be required.

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First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study

Cited by 104 publications

References 23 publications

Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study

Evidence of potent humoral immune activity in COVID-19-infected kidney transplant recipients

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