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Feldman AG, Beaty B, Everitt M, Goebel J, Kempe A, Pratscher L, Danziger-Isakov LA. Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs. Pediatr Transplant 2023; 27:e14513. [PMID: 36939212 PMCID: PMC10509306 DOI: 10.1111/petr.14513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/27/2022] [Accepted: 11/28/2022] [Indexed: 03/21/2023]
Abstract
BACKGROUND COVID-19 vaccine is recommended for individuals ages ≥6 months; however, whether vaccination should be mandated for transplant candidates and living donors remains controversial. This study assessed COVID-19 policies at US pediatric solid organ transplant centers. METHODS A 79-item survey was emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID-19 vaccine policies for transplant candidates and living donors and use of grafts from COVID-19-positive deceased donors. RESULTS The response rate was 77% (154/200). For children aged 5-15 years, 23% (35/154 centers) have a COVID-19 vaccine mandate, 27% (42/154) anticipate implementing a future mandate, and 47% (72/154) have not considered or do not anticipate implementing a mandate. For children ≥16 years, 32% (50/154 centers) have a COVID-19 vaccine mandate, 25% (39/154) anticipate implementing a future mandate, and 40% (62/154) have not considered or do not anticipate implementing a mandate. The top two reasons for not implementing a COVID-19 vaccine mandate were concerns about penalizing a child for their parent's decision and worsening inequities in transplant. Of 85 kidney and liver living donor centers, 32% (27/85) require vaccination of donors. Twenty percent (31/154) of centers accept organs from COVID-19-positive deceased donors. CONCLUSIONS There is great variation among pediatric SOT centers in both the implementation and details of COVID-19 vaccine mandates for candidates and living donors. To guide more uniform policies, further data are needed on COVID-19 disease, vaccine efficacy, and use of grafts from donors positive for COVID-19 in the pediatric transplant population.
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Affiliation(s)
- Amy G. Feldman
- Section of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Liver Transplant Center, Digestive Health Institute, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Brenda Beaty
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Melanie Everitt
- Pediatric Heart Transplant Program, Section of Pediatric Cardiology, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Jens Goebel
- Pediatrics and Human Development, Section of Pediatric Nephrology, Helen DeVos Children’s Hospital, Michigan State University, Grand Rapids, Michigan, USA
| | - Allison Kempe
- Department of Pediatrics, Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | | | - Lara A. Danziger-Isakov
- Immunocompromised Host Infectious Disease, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
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Vasconcelos MA, Mendonça ACQ, Colosimo EA, Nourbakhsh N, Martelli-Júnior H, Silva LR, Oliveira MCL, Pinhati CC, Mak RH, Simões E Silva AC, Oliveira EA. Outcomes and risk factors for death among hospitalized children and adolescents with kidney diseases and COVID-19: an analysis of a nationwide database. Pediatr Nephrol 2023; 38:181-191. [PMID: 35488136 PMCID: PMC9054113 DOI: 10.1007/s00467-022-05588-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/16/2022] [Accepted: 04/13/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with kidney diseases (KD) appear to be at particularly high risk for severe COVID-19. This study aimed to characterize the clinical outcomes and risk factors for COVID-19-related death in a large cohort of hospitalized pediatric patients with KD. METHODS We performed an analysis of all pediatric patients with KD and COVID-19 registered in SIVEP-Gripe, a Brazilian nationwide surveillance database, between February 16, 2020, and May 29, 2021. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk by using cumulative incidence function. RESULTS Among 21,591 hospitalized patients with COVID-19, 290 cases (1.3%) had KD. Of these, 59 (20.8%) had a fatal outcome compared with 7.5% of the non-KD cohort (P < 0.001). Pediatric patients with KD had an increased hazard of death compared with the non-KD cohort (Hazard ratio [HR] = 2.85, 95% CI 2.21-3.68, P < 0.0001). After adjustment, the factors associated with the death among KD patients were living in Northeast (HR 2.16, 95% CI 1.13-4.31) or North regions (HR 3.50, 95% CI 1.57-7.80), oxygen saturation < 95% at presentation (HR 2.31, 95% CI 1.30-4.10), and presence of two or more associated comorbidities (HR 2.10, 95% CI 1.08-4.04). CONCLUSIONS Children and adolescents with KD had a higher risk of death compared with the non-KD cohort. The higher risk was associated with low oxygen saturation at admission, living in socioeconomically disadvantaged regions, and presence of other pre-existing comorbidities. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Mariana A Vasconcelos
- Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana Carmen Q Mendonça
- Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Enrico A Colosimo
- Department of Statistics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Noureddin Nourbakhsh
- Division of Pediatric Nephrology, Rady Children's Hospital, University of California, La Jolla, San Diego, CA, USA
| | - Hercílio Martelli-Júnior
- Health Science/Primary Care Postgraduate Program, State University of Montes Claros (Unimontes), Montes Claros, MG, 39401-089, Brazil
| | - Ludmila R Silva
- Health Science/Postgraduate Program in Nursing, School of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, 30130-100, Brazil
| | - Maria Christina L Oliveira
- Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil
| | - Clara C Pinhati
- Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Robert H Mak
- Division of Pediatric Nephrology, Rady Children's Hospital, University of California, La Jolla, San Diego, CA, USA
| | - Ana Cristina Simões E Silva
- Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
- Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil
| | - Eduardo A Oliveira
- Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
- Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Federal University of Minas Gerais (UFMG), R. Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
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Transplantation Amid a Pandemic: The Fall and Rise of Kidney Transplantation in the United States. Transplant Direct 2022; 9:e1423. [PMID: 36582674 PMCID: PMC9750630 DOI: 10.1097/txd.0000000000001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/26/2022] [Indexed: 12/27/2022] Open
Abstract
Following the outbreak of coronavirus disease 2019 (COVID-19) in the United States, the number of kidney waitlist additions and living-donor and deceased-donor kidney transplants (LDKT/DDKT) decreased substantially but began recovering within a few months. Since then, there have been several additional waves of infection, most notably, the Delta and Omicron surges beginning in August and December 2021, respectively. Methods Using SRTR data, we compared observed waitlist registrations, waitlist mortality, waitlist removal due to deteriorating condition, LDKT, and DDKT over 5 distinct pandemic periods to expected events based on calculations from preepidemic data while accounting for seasonality and secular trends. Results Although the number of daily waitlist additions has been increasing since May 2020, the size of the active waitlist has consistently declined, reaching a minimum of 52 556 on February 27, 2022. The recent Omicron surge knocked LDKT from 25% below baseline (incidence rate ratio [IRR] = 0.690.750.81) during the Delta wave to 38% below baseline (IRR = 0.580.620.67). DDKT, however, was less affected by the Omicron wave (IRR = 0.850.890.93 and 0.880.920.96 during the Delta and Omicron waves, respectively). Waitlist death decreased from 56% above baseline (IRR = 1.431.561.70) during Delta to 41% above baseline during Omicron, whereas waitlist removal due to deteriorating condition remained at baseline/expected levels during the Delta wave (IRR = 0.931.021.12) and the Omicron wave (IRR = 0.991.071.16). Conclusions Despite exceptionally high COVID-19 incidence during the Omicron wave, the transplant system responded similarly to prior waves that imposed a lesser disease burden, demonstrating the transplant system's growing adaptations and resilience to this now endemic disease.
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Geetha D, Kronbichler A, Rutter M, Bajpai D, Menez S, Weissenbacher A, Anand S, Lin E, Carlson N, Sozio S, Fowler K, Bignall R, Ducharlet K, Tannor EK, Wijewickrama E, Hafidz MIA, Tesar V, Hoover R, Crews D, Varnell C, Danziger-Isakov L, Jha V, Mohan S, Parikh C, Luyckx V. Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions. Nat Rev Nephrol 2022; 18:724-737. [PMID: 36002770 PMCID: PMC9400561 DOI: 10.1038/s41581-022-00618-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected patients with kidney disease, causing significant challenges in disease management, kidney research and trainee education. For patients, increased infection risk and disease severity, often complicated by acute kidney injury, have contributed to high mortality. Clinicians were faced with high clinical demands, resource shortages and novel ethical dilemmas in providing patient care. In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.
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Affiliation(s)
- Duvuru Geetha
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | | | - Megan Rutter
- Department of Lifespan and Population Health, University of Nottingham, Nottingham, UK
| | - Divya Bajpai
- Department of Nephrology, Seth Gordhandas Sunderdas Medical College (GSMC) and the King Edward Memorial (KEM) Hospital, Mumbai, India
| | - Steven Menez
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Annemarie Weissenbacher
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Shuchi Anand
- Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Standford, California, USA
| | - Eugene Lin
- Department of Internal Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
| | - Nicholas Carlson
- Department of Nephrology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Research, The Danish Heart Foundation, Copenhagen, Denmark
| | - Stephen Sozio
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kevin Fowler
- Principal, Voice of the Patient Inc, St. Louis, Missouri, USA
| | - Ray Bignall
- Division of Nephrology and Hypertension, Nationwide Children's Hospital and Department of Paediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Kathryn Ducharlet
- Department of Renal Medicine, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Department of Nephrology and Palliative Care, St Vincent's Hospital Melbourne, Australia and Department of Medicine, University of Melbourne, Parkville, Australia
| | - Elliot K Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Renal Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Eranga Wijewickrama
- Consultant Nephrologist and Professor in the Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University Medical Unit, National Hospital of Sri Lanka and National Institute of Nephrology, Dialysis & Transplantation, Colombo, Sri Lanka
| | | | - Vladimir Tesar
- Department of Nephrology, Charles University, Prague, Czech Republic
| | - Robert Hoover
- Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Deidra Crews
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles Varnell
- Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Paediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Lara Danziger-Isakov
- Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USA
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- School of Public Health, Imperial College, London, UK
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Sumit Mohan
- Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Chirag Parikh
- Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Valerie Luyckx
- Associate Scientist, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
- Honorary Associate Professor, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Nephrologist, University Childrens Hospital, Zurich, Switzerland
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Lin GX, Kotheeranurak V, Chen CM, Hu BS, Rui G. Global research hotspots and trends in the field of spine surgery during the COVID-19 pandemic: A bibliometric and visual analysis. Front Surg 2022; 9:976546. [PMID: 36157412 PMCID: PMC9500354 DOI: 10.3389/fsurg.2022.976546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background The Coronavirus disease-2019 (COVID-19) significantly affected the healthcare and research systems, including spine surgery, throughout the world. A bibliometric analysis allows graphical visualization of the development of an academic field and its frontiers. Since research concerning spine surgery during the COVID-19 pandemic is being constantly upgraded, we conducted a bibliometric analysis of this literature to investigate the current status, research hotspots, and trends in this field. Methods We searched the Web of Science database for literature published (from December 1, 2019, to March 24, 2022) using the terms “COVID-19” OR “2019-nCoV” OR “SARS-CoV-2” AND “spine surgery” OR “spinal surgery” OR “discectomy” OR “decompression” OR “laminectomy” OR “interbody fusion” OR “pedicle screws.” Detailed bibliometric and visual analysis of the number of publications, geographical distribution, institutions, journals, authors, and keywords was done using CiteSpace, VOSviewer, and R-Bibliometrix. Results Of the initially screened 173 articles, we included 84 relevant articles—62 original articles, 10 editorial materials, 8 reviews, and 4 others. The United States, China, Egypt, and Argentina were most actively publishing in the field of spine surgery and COVID-19. The AOSpine International community contributed 7 articles (24 citations). The Hospital for Special Surgery (13.1%) and Johns Hopkins University (13.1%) were institutions with the most publications. Using the Law of Bradford, we found that World Neurosurgery, Global Spine Journal, and European Spine Journal are the core journals in this field, with P. K. Louie being the most influential author. “Elective surgery,” “intensive care,” “telehealth,” “patient satisfaction,” and “follow-up” had the strongest citation bursts. Conclusions During the COVID-19 pandemic, spine surgeons were more concerned with surgical timing, care, treatment, and patient’s quality of life. Accordingly, research hotspots in spine surgery during the pandemic shifted from “early healthcare” to “virus management” and “experience and education.”
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Affiliation(s)
- Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Vit Kotheeranurak
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
| | - Bao-Shan Hu
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
| | - Gang Rui
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted all aspects of healthcare including solid organ transplantation. In this review, we discuss the specific impact of COVID-19 on the pediatric solid organ transplant population including access to grafts for pediatric transplant candidates as well as COVID-19 disease manifestations in pediatric transplant recipients. We address the current knowledge of prevention and management of COVID-19 in pediatric transplant recipients and provide additional information regarding social distancing, infection prevention and return to school.
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Affiliation(s)
- Amy G Feldman
- Pediatric Liver Transplant Center, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States
| | - Lara A Danziger-Isakov
- Immunocompromised Host Infectious Disease, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, MLC 7017, Cincinnati, OH 45229, United States.
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Kemme S, Yoeli D, Sundaram SS, Adams MA, Feldman AG. Decreased access to pediatric liver transplantation during the COVID-19 pandemic. Pediatr Transplant 2022; 26:e14162. [PMID: 34633127 PMCID: PMC8646490 DOI: 10.1111/petr.14162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The COVID-19 pandemic has affected all aspects of the US healthcare system, including liver transplantation. The objective of this study was to understand national changes to pediatric liver transplantation during COVID-19. METHODS Using SRTR data, we compared waitlist additions, removals, and liver transplantations for pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). RESULTS Waitlist additions decreased by 25% during early COVID-19 (41.3/month vs. 55.4/month, p < .001) with black candidates most affected (p = .04). Children spent longer on the waitlist during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days, p < .001). There was a 38% decrease in liver transplantations during early COVID-19 (IRR 0.62, 95% CI 0.49-0.78), recovering to pre-pandemic rates during late COVID-19 (IRR 1.03, NS), and no change in percentage of living and deceased donors. White children had a 30% decrease in overall liver transplantation but no change in living donor liver transplantation (IRR 0.7, 95% CI 0.50-0.95; IRR 0.96, NS), while non-white children had a 44% decrease in overall liver transplantation (IRR 0.56, 95% CI 0.40-0.77) and 81% decrease in living donor liver transplantation (IRR 0.19, 95% CI 0.02-0.76). CONCLUSIONS The COVID-19 pandemic decreased access to pediatric liver transplantation, particularly in its early stage. There were no regional differences in liver transplantation during COVID-19 despite the increased national sharing of organs. While pediatric liver transplantation has resumed pre-pandemic levels, ongoing racial disparities must be addressed.
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Affiliation(s)
- Sarah Kemme
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Dor Yoeli
- Division of Transplant SurgeryColorado Center for Transplantation Care, Research and EducationUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Shikha S. Sundaram
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Megan A. Adams
- Division of Transplant SurgeryColorado Center for Transplantation Care, Research and EducationUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
| | - Amy G. Feldman
- Section of Gastroenterology, Hepatology, and NutritionDigestive Health InstituteUniversity of Colorado Denver School of Medicine and Children's Hospital ColoradoAuroraColoradoUSA
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Bansal N, Ovchinsky N, Foca M, Lamour JM, Kogan‐Liberman D, Hsu DT, Beddows K, Abraham L, Coburn M, Cunningham R, Nguyen T, Hayde N. COVID-19 infection in pediatric solid organ transplant patients. Pediatr Transplant 2022; 26:e14156. [PMID: 34633125 PMCID: PMC8646513 DOI: 10.1111/petr.14156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/10/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adult SOT recipients with COVID-19 have higher mortality rates when compared to general population. There is paucity of data on outcomes in pediatric SOT recipients. METHODS This is a cross-sectional study investigating the prevalence of COVID-19 infection and outcomes in pediatric SOT (heart, liver, and kidney) recipients. We extracted demographic and clinical characteristics and COVID-19 testing (PCR or [Ab] test) results from medical records. Clinical characteristics were compared between patients who were positive for COVID-19 (PCR or Ab) and those who did not, using Mann-Whitney, Student's t test, or chi-square test. p value <.05 was statistically significant. RESULTS A total of 108 SOT recipients with a median age of 13.1 (8.4, 17.8) years and median 4.2 (2.7, 7.9) years from transplant were checked for COVID-19 via a PCR or Ab test. A positive PCR was confirmed in 10 patients (9.3%), while 12 patients (11.1%) were positive for COVID-19 Ab. The patients who tested positive in our cohort were 9/50 (18%) heart, 6/68 (8.8%) kidney, and 7/50 (14%) liver transplant recipients. There were no differences in the clinical characteristics between patients with and without COVID-19 infection. All patients were either asymptomatic (50%) or had self-limiting symptoms. No changes were made to the immunosuppressive regimen. Only one patient was hospitalized and none had an oxygen requirement. CONCLUSIONS In our cohort of pediatric SOT recipients, COVID-19 infection was asymptomatic or mild. This data may aid clinicians in counseling patients and families in this increased-risk population.
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Affiliation(s)
- Neha Bansal
- Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Nadia Ovchinsky
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition Children’s Hospital at MontefioreBronxNew YorkUSA
| | - Marc Foca
- Division of Pediatric Infectious DiseasesChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Jacqueline M. Lamour
- Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Debora Kogan‐Liberman
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition Children’s Hospital at MontefioreBronxNew YorkUSA
| | - Daphne T. Hsu
- Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Kimberly Beddows
- Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Lincy Abraham
- Division of Pediatric CardiologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Maura Coburn
- Division of Pediatric NephrologyChildren’s Hospital at MontefioreBronxNew YorkUSA
| | - Ryan Cunningham
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition Children’s Hospital at MontefioreBronxNew YorkUSA
| | - Trang Nguyen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition Children’s Hospital at MontefioreBronxNew YorkUSA
| | - Nicole Hayde
- Division of Pediatric NephrologyChildren’s Hospital at MontefioreBronxNew YorkUSA
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Hu S, Wang X, Ma Y, Cheng H. Global Research Trends in Pediatric COVID-19: A Bibliometric Analysis. Front Public Health 2022; 10:798005. [PMID: 35252087 PMCID: PMC8888448 DOI: 10.3389/fpubh.2022.798005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/07/2022] [Indexed: 01/27/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) emerged in 2019 and has since caused a global pandemic. Since its emergence, COVID-19 has hugely impacted healthcare, including pediatrics. This study aimed to explore the current status and hotspots of pediatric COVID-19 research using bibliometric analysis. Methods The Institute for Scientific Information Web of Science core collection database was searched for articles on pediatric COVID-19 to identify original articles that met the criteria. The retrieval period ranged from the creation of the database to September 20, 2021. A total of 3,561 original articles written in English were selected to obtain data, such as author names, titles, source publications, number of citations, author affiliations, and countries where the studies were conducted. Microsoft Excel (Microsoft, Redmond, WA) was used to create charts related to countries, authors, and institutions. VOSviewer (Center for Science and Technology Studies, Leiden, The Netherlands) was used to create visual network diagrams of keyword, author, and country co-occurrence. Results We screened 3,561 publications with a total citation frequency of 30,528. The United States had the most published articles (1188 articles) and contributed the most with author co-occurrences. The author with the most published articles was Villani from the University of Padua, Italy. He also contributed the most co-authored articles. The most productive institution was Huazhong University of Science and Technology in China. The institution with the most frequently cited published articles was Shanghai Jiao Tong University in China. The United States cooperated most with other countries. Research hotspots were divided into two clusters: social research and clinical research. Besides COVID-19 and children, the most frequent keywords were pandemic (251 times), mental health (187 times), health (172 times), impact (148 times), and multisystem inflammatory syndrome in children (MIS-C) (144 times). Conclusion Pediatric COVID-19 has attracted considerable attention worldwide, leading to a considerable number of articles published over the past 2 years. The United States, China, and Italy have leading roles in pediatric COVID-19 research. The new research hotspot is gradually shifting from COVID-19 and its related clinical studies to studies of its psychological and social impacts on children.
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Affiliation(s)
- Siyu Hu
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Xi Wang
- Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, China
| | - Yucong Ma
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hang Cheng
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Hang Cheng
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10
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Mali VP, Aw M, Ng KH, Karthik SV, Tan M, Teo S, Lau PYW, Nyo YL, Loh DSKL, Tiong HY, Quak SH, Yap HK. Paediatric living-donor liver and kidney transplantation during COVID-19. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:119-121. [PMID: 35224610 DOI: 10.47102/annals-acadmedsg.2021272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Vidyadhar Padmakar Mali
- Department of Paediatric Surgery, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
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11
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da Costa KM, Khouri TEF, Saxena AK. Focus of Pediatric Surgical Reports During the SARS-CoV-2 Pandemic: A Narrative Review. J Indian Assoc Pediatr Surg 2022; 27:517-520. [PMID: 36530808 PMCID: PMC9757783 DOI: 10.4103/jiaps.jiaps_12_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/14/2022] [Accepted: 06/18/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) pandemic impacted surgical activity at health-care facilities and led to significant changes in the characteristics of publications in medical journals. This is a narrative review that outlines the focus of pediatric surgical reports during the ongoing COVID-19 pandemic. METHODS Publications on pediatric surgery during the pandemic were carefully reviewed, and data emerging from reports on COVID-19 were selected to address: (1) the impact of COVID-19 on pediatric surgical procedures; (2) children undergoing surgical intervention; and (3) expansion of telemedicine. RESULTS Regarding surgical activity in tertiary hospitals, there was a reduction in the number of elective surgeries, with reports of an increase in complicated appendicitis and in testicular torsions with symptoms for more than 6 h. The pandemic impacted specific surgical fields, with reports on trauma, appendectomies, urology, cardiac surgery, and kidney transplant. In children positive for COVID-19 that underwent surgery, postoperative complications were more indicative of the primary surgical pathology and there were no postoperative deaths. In a report of universal screening, <1% of children had positive reverse transcription-polymerase chain reaction (RT-PCR). In a report addressing telemedicine during the pandemic, it was well evaluated by both pediatric surgeons and patients' families, but most surgical departments did not provide the service. CONCLUSIONS The pandemic brought significant changes in surgical care. As expected, there was a reduction in elective surgeries, RT-PCR-positive children did not present worse postoperative outcomes than negative ones but there is still a paucity of data regarding COVID-19 children, and telemedicine may play an important role in health care, especially in times of social distancing.
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Affiliation(s)
- Karina Miura da Costa
- Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK,Department of Health Sciences, Cesumar University (Unicesumar), Maringá, Paraná
| | | | - Amulya Kumar Saxena
- Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK,Address for correspondence: Dr. Amulya Kumar Saxena, Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK. E-mail:
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12
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Bjornstad EC, Seifert ME, Sanderson K, Feig DI. Kidney implications of SARS-CoV2 infection in children. Pediatr Nephrol 2022; 37:1453-1467. [PMID: 34453600 PMCID: PMC8397606 DOI: 10.1007/s00467-021-05249-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 12/15/2022]
Abstract
Research indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection can impact every organ, and the effects can range from asymptomatic to severe disease. Since it was first discovered in December 2019, our understanding has grown about its impact on kidney disease. In general, children have less severe disease than adults, and this tendency appears to extend to special pediatric kidney populations (e.g., chronic kidney disease and immunosuppressed patients with solid organ transplants or nephrotic syndrome). However, in a fraction of infected children, SARS-CoV2 causes an array of kidney manifestations, ranging from acute kidney injury to thrombotic microangiopathy, with potential implications for increased risk of morbidity and mortality. Additional considerations surround the propensity for clotting extracorporeal circuits in children with SARS-CoV2 infection that are receiving kidney replacement therapy. This review provides an update on our current understanding of SARS-CoV2 for pediatric nephrologists and highlights knowledge gaps to be addressed by future research during this ongoing pandemic, particularly the social disparities magnified during this period.
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Affiliation(s)
- Erica C Bjornstad
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Michael E Seifert
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Keia Sanderson
- Department of Medicine, Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel I Feig
- Department of Pediatrics, Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
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13
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Sabetkish N, Rahmani A. The overall impact of COVID-19 on healthcare during the pandemic: A multidisciplinary point of view. Health Sci Rep 2021; 4:e386. [PMID: 34622020 PMCID: PMC8485600 DOI: 10.1002/hsr2.386] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS The Coronavirus disease 2019 (COVID-19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID-19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post-COVID era and the need for future medical revolutions. METHODS A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. RESULTS We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID-19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check-ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. CONCLUSION Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post-COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.
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Affiliation(s)
- Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical CenterTehran University of Medical SciencesTehranIran
- ImmunologyAsthma and Allergy Research Institute, Tehran University of Medical SciencesTehranIran
| | - Alireza Rahmani
- Research Center for Prevention of Cardiovascular DiseaseInstitute of Endocrinology & Metabolism, Iran University of Medical SciencesTehranIran
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14
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15
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Yanev I, Gagnon M, Cheng MP, Paraskevas S, Kumar D, Dragomir A, Sapir-Pichhadze R. Kidney Transplantation in Times of Covid-19: Decision Analysis in the Canadian Context. Can J Kidney Health Dis 2021; 8:20543581211040332. [PMID: 34540237 PMCID: PMC8447095 DOI: 10.1177/20543581211040332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic impacted transplant programs across Canada. OBJECTIVE We evaluated the implications of delays in transplantation among Canadian end-stage kidney disease (ESKD) patients to allow pretransplant vaccination. DESIGN We used a Markov microsimulation model and ESKD patient perspective to study the effectiveness (quality-adjusted life years [QALY]) of living (LD) or deceased donor (DD) kidney transplantation followed by 2-dose SARS-CoV-2 vaccine versus delay in LD ("Delay LD") or refusal of DD offer ("Delay DD") to receive 2-dose SARS-CoV-2 vaccine pretransplant. SETTING Canadian dialysis and transplant centers. PATIENTS We simulated a 10 000-waitlisted ESKD patient cohort, which was predictively modeled for a lifetime horizon in monthly cycles. MEASUREMENTS Inputs on patient and graft survival estimates by patient, LD or DD characteristics, were extracted from the Treatment of End-Stage Organ Failure in Canada, Canadian Organ Replacement Register, 2009 to 2018. In addition, a literature review provided inputs on quality of life, SARS-CoV-2 transmissibility, new variants of concern, mortality risk, and antibody responses to 2-dose SARS-CoV-2 mRNA vaccines. METHODS We conducted base case, scenario, and sensitivity analyses to illustrate the impact of patient, donor, vaccine, and pandemic characteristics on the preferred strategy. RESULTS In the average waitlisted Canadian patient, receiving 2-dose SARS-CoV-2 vaccine post-transplant provided an effectiveness of 22.32 (95% confidence interval: 22.00-22.7) for LD and 19.34 (19.02-19.67) QALYs for DD. Delaying transplants for 6 months to allow 2-dose SARS-CoV-2 vaccine before LD and DD transplant yielded effectiveness of 22.83 (21.51-23.14) and 20.65 (20.33-20.96) QALYs, respectively. Scenario analysis suggested a benefit to short delays in DD transplants to receive 2-dose SARS-CoV-2 vaccine in waitlisted patients ≥55 years. Two-way sensitivity analysis suggested decreased effectiveness of the strategy prioritizing 2-dose SARS-CoV-2 vaccine prior to DD transplant the longer the delay and the higher the Kidney Donor Risk Index of the eventual DD transplant. When assessing the impact of SARS-CoV-2 variants of concern (infection rates ≥10-fold and associated mortality ≥3-fold vs base case), we found short delays to allow 2-dose SARS-CoV-2 vaccine administration pretransplant to be preferable. LIMITATIONS Risks associated with nosocomial exposure of LDs were not considered. There was uncertainty regarding input parameters related to SARS-CoV-2 infection, new variants, and COVID-19 severity in ESKD patients. Given rollout of population-level SARS-CoV-2 vaccination, we assumed a linear decrease in infection rates over 1 year. Proportions of patients mounting an antibody response to 2-dose SARS-CoV-2 mRNA vaccines were considered in lieu of data on vaccine efficacy in dialysis and following transplantation. Non-age-stratified annual mortality rates were used for waitlisted candidates. CONCLUSIONS Our analyses suggest that short delays allowing pretransplant vaccination offered comparable to greater effectiveness than pursuing transplantation without delay, proposing transplant candidates should be prioritized to receive at least 2 doses of SARS-CoV-2 vaccine. Our scenario and sensitivity analyses suggest that caution must be exercised when declining DD offers in patients offered low risk DD and who are likely to incur significant delays in access to transplantation. While population-level herd immunity may decrease infection risk in transplant patients, more data are required on vaccine efficacy against SARS-CoV-2 and variants of concern in ESKD, and how efficacy may be modified by a third vaccine dose, maintenance immunosuppression and timing of induction and rejection therapies.
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Affiliation(s)
- Ivan Yanev
- Centre for Outcomes Research and
Evaluation, The Research Institute of the McGill University Health Centre, Montreal,
QC, Canada
| | - Michael Gagnon
- Division of Nephrology and Multi-Organ
Transplant Program, Department of Medicine, McGill University, Montreal, QC,
Canada
| | - Matthew P. Cheng
- Division of Infectious Diseases,
Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
- Division of Medical Microbiology,
Department of Laboratory and Pathology Medicine, McGill University Health Centre,
Montréal, QC, Canada
| | - Steven Paraskevas
- Division of General Surgery and
Multi-Organ Transplant Program, Department of Surgery, McGill University Health
Centre, Montréal, QC, Canada
| | - Deepali Kumar
- Transplant Infectious Diseases and
Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada
| | - Alice Dragomir
- Centre for Outcomes Research and
Evaluation, The Research Institute of the McGill University Health Centre, Montreal,
QC, Canada
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research and
Evaluation, The Research Institute of the McGill University Health Centre, Montreal,
QC, Canada
- Division of Nephrology and Multi-Organ
Transplant Program, Department of Medicine, McGill University, Montreal, QC,
Canada
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16
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Gaussen A, Hornby L, Rockl G, O'Brien S, Delage G, Sapir-Pichhadze R, Drews SJ, Weiss MJ, Lewin A. Evidence of SARS-CoV-2 Infection in Cells, Tissues, and Organs and the Risk of Transmission Through Transplantation. Transplantation 2021; 105:1405-1422. [PMID: 33724248 DOI: 10.1097/tp.0000000000003744] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus responsible for the coronavirus disease 2019 (COVID-19) pandemic has raised concerns for programs overseeing donation and transplantation of cells, tissues, and organs (CTO) that this virus might be transmissible by transfusion or transplantation. Transplant recipients are considered particularly vulnerable to pathogens because of immunosuppression, and SARS-CoV-2 is likely to generate complications if contracted. Several signs and symptoms observed in COVID-19 positive patients reflect damage to multiple organs and tissues, raising the possibility of extrapulmonary SARS-CoV-2 infections and risk of transmission. At the beginning of the pandemic, a consensus has emerged not to consider COVID-19 positive patients as potential living or deceased donors, resulting in a global decrease in transplantation procedures. Medical decision-making at the time of organ allocation must consider safely alongside the survival advantages offered by transplantation. To address the risk of transmission by transplantation, this review summarizes the published cases of transplantation of cells or organs from donors infected with SARS-CoV-2 until January 2021 and assesses the current state of knowledge for the detection of this virus in different biologic specimens, cells, tissues, and organs. Evidence collected to date raises the possibility of SARS-CoV-2 infection and replication in some CTO, which makes it impossible to exclude transmission through transplantation. However, most studies focused on evaluating transmission under laboratory conditions with inconsistent findings, rendering the comparison of results difficult. Improved standardization of donors and CTO screening practices, along with a systematic follow-up of transplant recipients could facilitate the assessment of SARS-CoV-2 transmission risk by transplantation.
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Affiliation(s)
- Amaury Gaussen
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | - Laura Hornby
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Canadian Blood Services, Ottawa, ON, Canada
| | - Gary Rockl
- Medical Affairs and Innovation, Héma-Québec, Québec, QC, Canada
| | | | - Gilles Delage
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of McGill University Health Centre, Montréal, QC, Canada
- Division of Nephrology and the Multi Organ Transplant Program, Royal Victoria Hospital, McGill University Health Centre, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Steven J Drews
- Canadian Blood Services, Edmonton, AB, Canada
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Matthew J Weiss
- Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec, Université Laval Research Center, Québec, QC, Canada
- Pediatrics Department, Intensive Care Division, Faculté de Médecine, Université Laval, Québec, QC, Canada
- Transplant Québec, Montréal, QC, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, QC, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
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17
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Chang SH, Wang M, Lentine KL, Merzkani M, Alhamad T. Solid organ transplantation during the COVID-19 pandemic in the United States. Transpl Int 2021; 34:1319-1321. [PMID: 33942425 PMCID: PMC8236930 DOI: 10.1111/tri.13898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/24/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Su-Hsin Chang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Mei Wang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Krista L Lentine
- Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USA
| | - Massini Merzkani
- Division of Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tarek Alhamad
- Division of Nephrology, Washington University School of Medicine, St. Louis, MO, USA.,Transplant Epidemiology Research Collaboration (TERC), Institute of Public Health, Washington University School of Medicine, St. Louis, MO, USA
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18
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Alshami A, Al Attas R, Azzam A, Mohammed A, Al-Quhaidan N. Detection of SARS-CoV-2 antibodies in pediatric kidney transplant patients. BMC Nephrol 2021; 22:123. [PMID: 33827461 PMCID: PMC8025893 DOI: 10.1186/s12882-021-02325-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/25/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The seroprevalence of SARS-CoV-2 infection has been studied in immunocompetent children. However, data in the pediatric kidney transplant population (PKT) are lacking. METHODS Using two commercial immunoassays that measured IgG antibodies against SARS-CoV-2 spike protein and IgG against the nucleocapsid (N) protein, we screened 72 PKT recipients who attended the outpatient clinic for routine blood work. The majority of patients with positive serology underwent an additional serology test at least once during subsequent clinical follow-up. Patients were confirmed to have SARS-CoV-2 infection if they had two positive tests. RESULTS Eight patients out of the 72 screened (11.1%) had positive results for SARS-CoV-2 IgG antibodies in both serological tests. Of those who tested positive, 4 had positive SARS-CoV-2 PCR results before screening. All patients were asymptomatic or had a history of mild symptoms. All tested patients had persistently positive antibodies at a median follow-up time of 75 days (IQR, 44.5, 86.5 days). One patient had a positive PCR test at 75 days and a positive serology test at 120 days post infection. CONCLUSION The seroprevalence of SARS-CoV-2 was relatively high (11.1%) in our population. Although all patients were asymptomatic or mildly symptomatic, they mounted a strong humoral immune response that persisted for a few months despite being on triple immunosuppressants. These findings have positive implications regarding vaccination efficacy in this group.
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Affiliation(s)
- Alanoud Alshami
- Division of Pediatric Nephrology and Kidney Transplant, Multiorgan Transplant Center, King Fahad Specialist Hospital-Dammam/Saudi Arabia, Dammam, Saudi Arabia.
| | - Rabab Al Attas
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia, Dammam, Saudi Arabia
| | - Ahmad Azzam
- Division of Pediatric Nephrology and Kidney Transplant, Multiorgan Transplant Center, King Fahad Specialist Hospital-Dammam/Saudi Arabia, Dammam, Saudi Arabia
| | - Amani Mohammed
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia, Dammam, Saudi Arabia
| | - Norah Al-Quhaidan
- Division of Immunology, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia, Dammam, Saudi Arabia
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19
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Lobritto S, Danziger-Isakov L, Michaels MG, Mazariegos GV. Impact of COVID-19 Pandemic on Pediatrics and Pediatric Transplantation Programs. Front Pediatr 2020; 8:612627. [PMID: 33363069 PMCID: PMC7758251 DOI: 10.3389/fped.2020.612627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/16/2020] [Indexed: 12/15/2022] Open
Abstract
COVID-19 has dramatically altered the health care landscape and disrupted global health and world economics in ways that are still being measured. Its impact on children with chronic conditions or those undergoing transplantation is evolving. The organ specific manifestations in children will be reviewed and treatment strategies outlined. The impact on pediatric transplantation in the United States over the initial 6 months of the pandemic has shown significant regional variation and lags persist in resumption of normal transplant activity, particularly for living related transplantation. Finally, guidelines regarding return to school will be discussed.
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Affiliation(s)
- Steven Lobritto
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Lara Danziger-Isakov
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH, United States
| | - Marian G Michaels
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - George V Mazariegos
- Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
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