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Fayyaz A, Pozzerle J, Antony SJ. A Retrospective Study Comparing Mortality Rates between Vaccinated and Unvaccinated Kidney Transplant Recipients. Infect Disord Drug Targets 2024; 24:72-75. [PMID: 38757699 DOI: 10.2174/0118715265254866231121053403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 05/18/2024]
Abstract
Background: With the emergence of vaccines for COVID-19, mortality and severity of disease have decreased. However, patients with certain comorbidities, such as immunosuppression, CKD, and renal transplant, still have higher mortality rates as compared to the general population. Current data suggests that the risk of developing COVID-19 among transplant patients was reported to be about 5%, which is significantly higher than the risk rate of 0.3% in the general population. Studies utilizing larger sample sizes (i.e., multiple cohorts, sites, hospitals) comparing COVID-19 outcomes among renal transplant patients with a control group are lacking. Objective: The purpose of this descriptive study was to compare the mortality rate between vaccinated and unvaccinated kidney transplant recipients. Methods: Participants were recruited at a community-based transplant clinic in West Texas. Results: Among the group of participants who tested positive for COVID-19 between 2020 and 2022, higher mortality rates and longer hospital stays were noted among those unvaccinated (72% unvaccinated had greater than 5-day length of stay vs. 33% vaccinated). Conclusion: Our study suggests that vaccination against COVID-19 decreases mortality rates in kidney transplant recipients. .
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Affiliation(s)
- Anaam Fayyaz
- Internal Medicine Resident Physician, HCA Las Palmas Del Sol Medical Center, El Paso, Texas, USA
| | - Judy Pozzerle
- Quality Coordinator Transplant Services, Las Palmas Medical Center, El Paso, Texas, USA
| | - Suresh J Antony
- Clinical Prof. of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
- Burrell College of Osteopathic Medicine, Las Cruces, N.M, 88001, USA
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Zhang C, Kodali L, Mour G, Jadlowiec C, Mathur AK. The impact of COVID-19 on kidney transplant care. Front Med (Lausanne) 2023; 9:1093126. [PMID: 36698806 PMCID: PMC9868174 DOI: 10.3389/fmed.2022.1093126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
The SARS-CoV-2 virus precipitated the coronavirus 2019 (COVID-19) pandemic, which placed considerable strain on healthcare systems and necessitated immediate and rapid alterations in the delivery of healthcare. In the transplant population, COVID-19 directly impacts an inherently vulnerable population in the setting of immunosuppression and co-morbidities, but also further complicates the clinical evaluation and management of kidney transplant candidates and recipients in a strained healthcare environment being challenged by the pandemic. Many transplant centers around the world saw mortality rate spikes in organ recipients related to COVID-19, and changes in care delivery abound. This review evaluates the care of the kidney transplant patient through all phases of the process including pre-operative evaluations, perioperative care, post-transplantation considerations, and how the global pandemic has changed the way we care for our patients.
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Affiliation(s)
- Chi Zhang
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester, Rochester, MN, United States
| | - Lavanya Kodali
- Division of Nephrology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Girish Mour
- Division of Nephrology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Caroline Jadlowiec
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Amit K. Mathur
- Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester, Rochester, MN, United States,*Correspondence: Amit K. Mathur,
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Mukherjee T, Bonu R, Prakash GK, Sankaran S, Ballal S. Spectrum of COVID-19 infections in renal transplant recipients: A single-center case series. INDIAN JOURNAL OF TRANSPLANTATION 2023. [DOI: 10.4103/ijot.ijot_52_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Marbun MBH, Saragih RJ, Andina T. Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series. Int J Nephrol 2022; 2022:9636624. [PMID: 36035233 PMCID: PMC9411004 DOI: 10.1155/2022/9636624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Kidney transplant recipients (KTRs) were reported to be at higher risk of developing severe coronavirus disease-2019 (COVID-19). Despite being one of the most impacted countries, little is known about KTRs with COVID-19 in Indonesia. This report aims to explore the management strategies and short-term clinical outcomes of KTRs with COVID-19 in an Indonesian transplant center. Methods We observed KTRs who were admitted following COVID-19 diagnosis. Anamnesis, physical, laboratory, and radiologic examinations were performed. Demographic and transplant histories were recorded, along with symptoms, vaccination status, and management related to COVID-19. Results Nineteen KTRs were observed and 14 (73.6%) were male. The most common presenting symptoms were fever, cough, and shortness of breath. Nine (47.3%) KTRs had severe-critical COVID-19. The mortality rate was 42.1%. Acute kidney injury (AKI) was present in six (31.6%) of KTRs, five (83.3%) of whom were nonsurvivors. The median D-dimer level was higher in nonsurvivors (5,800 versus 670 μL), while other laboratory parameters were comparable. Seven (36.8%) KTRs were vaccinated. The mortality rates of vaccinated and unvaccinated KTRs were 14.2% and 70%, respectively. Antiviral therapy, anticoagulant, intravenous immunoglobulin, and tocilizumab were prescribed to 89.5%, 89.5%, 15.8%, and 10.5%, respectively. Immunosuppressive therapy (IST) was halted in 68% of KTRs, among which 61.5% passed away. Conclusion The clinical presentation of COVID-19 in KTRs was similar to that in the general population, whereas the mortality rate was higher. Management strategies for KTRs with COVID-19 should include prevention of AKI and hypercoagulation. Vaccination seems to be beneficial for KTRs, while temporary withdrawal of IST does not.
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Affiliation(s)
- Maruhum Bonar H. Marbun
- Division of Nephrology and Hypertension, Department of Internal Medicine, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Riahdo J. Saragih
- Division of Nephrology and Hypertension, Department of Internal Medicine, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Tantika Andina
- Division of Nephrology and Hypertension, Department of Internal Medicine, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Dincer MT, Trabulus S, Seyahi N. Favipiravir therapy for Covid-19 infection and tacrolimus toxicity in a kidney transplant patient on chronic eculizumab therapy. THE NATIONAL MEDICAL JOURNAL OF INDIA 2022; 35:232-234. [PMID: 36715032 DOI: 10.25259/nmji_378_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Although the latest data show that complement activation has an essential role in the pathogenesis and severity of Covid-19, the data on the prognosis of patients using complement inhibitors during Covid-19 infection are scarce. There is no specific treatment for Covid-19 yet. The introduction of novel agents such as favipiravir may affect metabolism of immunosuppressive drugs. We report the clinical course of Covid-19 in a kidney transplant patient with atypical haemolytic uraemic syndrome on chronic eculizumab therapy. The patient had mild Covid-19 but had severe tacrolimus toxicity, which may be associated with favipiravir and eculizumab. The mild course of Covid-19 in our patient is encouraging for eculizumab use; on the other hand, unusually high levels of tacrolimus that we observed underlines the importance of frequent drug level monitoring in transplanted patients who are receiving new drugs.
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Affiliation(s)
- Mevlut Tamer Dincer
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, Istanbul 34360, Turkey
| | - Sinan Trabulus
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, Istanbul 34360, Turkey
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, Istanbul 34360, Turkey
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A Comprehensive Comparison of Clinical Presentation and Outcomes of Kidney Transplant Recipients with COVID-19 during Wave 1 versus Wave 2 at a Tertiary Care Center, India. Int J Nephrol 2022; 2022:9088393. [PMID: 35669496 PMCID: PMC9165617 DOI: 10.1155/2022/9088393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 05/07/2022] [Indexed: 01/08/2023] Open
Abstract
Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.
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Cacho J, Burgos E, Molina M, Villegas A, Pérez M, Cañas L, Taco O, Juega J, Lauzurica R. Remdesivir in kidney transplant patients with SARS-CoV-2 pneumonia. Nefrologia 2022; 42:311-317. [PMID: 36210620 PMCID: PMC9343742 DOI: 10.1016/j.nefroe.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/11/2021] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Remdesivir is the only antiviral treatment that has been shown to be useful against SARS-CoV-2 infection. It shorts hospitalization time compared to placebo. Its effects in Kidney transplant (KT) patients are limited to some published cases. METHODS We performed a retrospective observational study that included all KT patients admitted between August 01, 2020 and December 31, 2020 with SARS-CoV-2 pneumonia who received remdesivir. The objective of this study was to describe the experience of a cohort of KT patients treated with remdesivir. DISCUSSION A total of 37 KT patients developed SARS-CoV-2 infection, 7 of them received treatment with remdesivir. The rest of the patients did not receive the drug due to either CKD-EPI less than 30 mL/min or they did not present clinical criteria. In addition to remdesivir, all pacients received dexamethasone and anticoagulation therapy. 4 were men, the median age was 59 (53-71) years. Median time from transplantation was 43 (16-82) months. Chest X-rays of all patients showed pulmonary infiltrates and required low oxygen flow therapy upon admission, requiring high flow nasal therapy in 3 cases. Only 2 cases presented deterioration of the graft function, not requiring hemodialysis in any case, and all recovered renal function at hospital discharge. 2 patients rise up 1.5 times the liver function test. No patient died or required admission to the critical care unit. Median days of admission was 12 (9-27) days. CONCLUSIONS Our study suggests that the use of remdesivir could be useful in KT patients with SARS-CoV-2 pneumonia without side effects. Additional studies are necessary with a larger number of patients to improve the knowledge of this drug in SARS-CoV-2 infection.
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Affiliation(s)
- Judit Cacho
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Elena Burgos
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Molina
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - Andrés Villegas
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Mónica Pérez
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Laura Cañas
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Omar Taco
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Javier Juega
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Ricardo Lauzurica
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
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COVID 19 induced acute pancreatitis in patients with renal impairment: report of five cases. Clin J Gastroenterol 2022; 15:826-833. [PMID: 35471693 PMCID: PMC9038997 DOI: 10.1007/s12328-022-01633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/31/2022] [Indexed: 01/08/2023]
Abstract
COVID 19 infection is an ongoing pandemic that the world is facing currently. Though SARS-CoV2 infection mainly involves the lungs, it is known to affect other organs like kidneys, brain, heart, endocrine organs and gastrointestinal system. It is hypothesized that the ACE2 and transmembrane serine protease 2 which are expressed in the beta cells of the pancreas are the entry receptors for the SARS-CoV-2 virus, thus causing pancreatitis. A retrospective review of clinical records at our institution during the COVID 19 pandemic from 2019 to 2020 was carried out to find patients with COVID 19 infection presenting with acute pancreatitis. Additionally, a review of literature was conducted about COVID 19 patients presenting with pancreatitis in chronic kidney disease and renal transplantation recipients. Five patients with COVID 19 infection presented with acute pancreatitis during the 2019–2020 pandemic period. All patients were males and mean age of the patients was 48 ± 20 years. Out of 5 patients, 3 were chronic kidney disease patients, 2 were renal transplantation recipients. COVID 19 infection was the cause of acute pancreatitis in all 5 cases. Out of 5, 1 patient had acute necrotizing pancreatitis and the rest had mild to moderate severity pancreatitis. All patients recovered except the patient with acute necrotizing pancreatitis who succumbed to the illness. One patient with chronic kidney disease became dialysis dependent post recovery from pancreatitis. In all 5 patients, there was no correlation between the severity of COVID ARDS and the severity of pancreatitis. There was no correlation between the severity of pancreatitis and the elevation of inflammatory markers. In patients presenting with pancreatitis, we have to keep in mind COVID 19 infection along with other known aetiologies of acute pancreatitis.
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Papalois V, Kotton CN, Budde K, Torre-Cisneros J, Croce D, Halleck F, Roze S, Grossi P. Impact of COVID-19 on Global Kidney Transplantation Service Delivery: Interim Report. Transpl Int 2022; 35:10302. [PMID: 35418803 PMCID: PMC8996250 DOI: 10.3389/ti.2022.10302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/23/2022] [Indexed: 12/15/2022]
Abstract
This article gives a personal, historical, account of the impact of the COVID-19 pandemic on transplantation services. The content is based on discussions held at two webinars in November 2020, at which kidney transplantation experts from prestigious institutions in Europe and the United States reflected on how the pandemic affected working practices. The group discussed adaptations to clinical care (i.e., ceasing, maintaining and re-starting kidney transplantations, and cytomegalovirus infection management) across the early course of the pandemic. Discussants were re-contacted in October 2021 and asked to comment on how transplantation services had evolved, given the widespread access to COVID-19 testing and the roll-out of vaccination and booster programs. By October 2021, near-normal life and service delivery was resuming, despite substantial ongoing cases of COVID-19 infection. However, transplant recipients remained at heightened risk of COVID-19 infection despite vaccination, given their limited response to mRNA vaccines and booster dosing: further risk-reduction strategies required exploration. This article provides a contemporaneous account of these different phases of the pandemic from the transplant clinician’s perspective, and provides constructive suggestions for clinical practice and research.
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Affiliation(s)
- Vassilios Papalois
- Renal and Transplant Directorate, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Vassilios Papalois,
| | - Camille N. Kotton
- Infectious Diseases Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Julian Torre-Cisneros
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Reina Sofía University Hospital, University of Cordoba, Cordoba, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Davide Croce
- Research Centre in Health Economics and Healthcare Management, Carlo Cattaneo University, Castellanza, Italy
| | - Fabian Halleck
- Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stéphane Roze
- Vyoo Agency, Health-Economics Department, Villeurbanne, France
| | - Paolo Grossi
- Department of Infectious Diseases, University of Insubria, Varese, Italy
- Infectious and Tropical Diseases Unit, ASST-Sette Laghi, Varese, Italy
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Jasuja S, Jha V, Sagar G, Bahl A, Verma S, Jasuja N, Kaur J. Post vaccination analysis of anti-spike antibody responses in kidney transplant recipients with and without COVID-19 infection in a tertiary care center, India. Clin Kidney J 2022; 15:1312-1321. [PMID: 35747093 PMCID: PMC8903484 DOI: 10.1093/ckj/sfac057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
To investigate the anti-spike antibody response to vaccination in Kidney transplant recipients (KTRs) previously infected with SARS-CoV-2 as compared to KTRs with no history of COVID-19 from India.
Methods
SARS-CoV-2 spike immunoglobulin (Ig) G antibody response was measured in 105 post COVID-19 KTRs with PCR confirmed SARS-CoV-2 infection who received either no vaccination (cohort 1), single (cohort 2) or two doses (cohort 3) of vaccine and compared to 103 two-dose vaccinated COVID-19 naïve KTRs with no history of COVID-19 (cohort 4).
Results
Out of 103 COVID-19 naïve two-dose vaccinated KTRs, less than 50% became seropositive with anti-spike antibody titres > 50AU/mL subsequent to complete vaccination, the seroconversion rate being comparable in subjects receiving CovishieldTM versus CovaxinTM vaccines. However, the seropositive KTRs vaccinated with CovishieldTM had higher anti-spike antibody titres as compared to those who received CovaxinTM. We observed higher anti-SARS-CoV-2 spike antibody levels in post COVID-19 KTRs after 1 dose of vaccine as compared with COVID-19 naïve two-dose vaccinated KTRs. Importantly, the second dose in post COVID-19 KTRs did not significantly increase anti-spike antibody levels compared with the single dose recipients.
Conclusions
Our data presents that in KTRs with previous SARS-CoV-2 infection a single dose of vaccine (CovishieldTM) may be effective in mounting optimal immune response. In contrast, COVID-19 naïve two-dose vaccinated KTRs respond poorly (<50%) to current recommendation of a two-dose regimen in India.
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Affiliation(s)
- Sanjiv Jasuja
- Indraprastha Apollo Hospital, Department Of Nephrology, New Delhi, India
| | - Vivekanand Jha
- George Institute for Global Health, UNSW, New Delhi, India
- School of Public Health, Imperial College, London, UK
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Gaurav Sagar
- Indraprastha Apollo Hospital, Department Of Nephrology, New Delhi, India
| | - Anupam Bahl
- Indraprastha Apollo Hospital, Department Of Nephrology, New Delhi, India
| | - Shalini Verma
- AVATAR Foundation, Department of Clinical Research, New Delhi, India
| | - Neharita Jasuja
- AVATAR Foundation, Department of Clinical Research, New Delhi, India
| | - Jasmeet Kaur
- Dr Lal PathLabs Ltd, National Reference Laboratory, Department of Histocompatibility and Transplant Immunology, New Delhi, India
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global healthcare crisis. Kidney transplant (KTx) patients and the patients with chronic kidney disease are two of the most vulnerable populations to the risks of coronavirus disease 2019 (COVID-19). A systematic literature search on PubMed and Web of Science was conducted. We analyzed published case reports, case series and articles on COVID-19’s clinical presentation, management, outcomes and vaccination among kidney transplant recipients. A total of 33 studies were included in the study, which included 1676 KTx recipients and 108 waiting list patients infected with COVID-19. These studies reported the clinical presentation, management and immunosuppressive adjustment among the KTx recipients. The remaining studies focused on other aspects, such as vaccination and transplantation, during the COVID-19 pandemic. Mortality due to COVID-19 was observed to be the highest for KTx recipients, followed by patients on hemodialysis, and lowest in the general population. There is no definitive treatment of COVID-19 yet, and managing transplant patients is enigmatic of this: the treatment is based on symptom management. There is an urgent need for guidelines on managing kidney transplant recipients and immunosuppressive adjustments for the course of COVID-19 treatment.
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Latief M, Abbas F, Iqbal M, Hassan Z, Goud LN, Shafi O. Remdesivir in renal transplant patients with coronavirus disease 2019: An observational study. INDIAN JOURNAL OF TRANSPLANTATION 2022. [DOI: 10.4103/ijot.ijot_54_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rahimzadeh H, Tamehri Zadeh SS, Khajavi A, Saatchi M, Reis LO, Guitynavard F, Dehghani S, Soleimani V, Aghamir SMK. The Tsunami of COVID-19 Infection Among Kidney Transplant Recipients: A Single-Center Study from Iran. J Epidemiol Glob Health 2021; 11:389-396. [PMID: 34826130 PMCID: PMC8617358 DOI: 10.1007/s44197-021-00015-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/14/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although most evidence supports the fact that kidney transplant (KT) recipients are at significant risk of morbidity and mortality, risk factors of accruing COVID-19 in this population have remained poorly defined. METHODS All KT recipients who had been transplanted in Sina Hospital and were actively followed between March 1996 and January 2021 were enrolled in a retrospective manner. The demographic characteristics, immunosuppressive treatment before KT, and death were gathered by calling patients with a designed questionnaire. RESULTS 108 (about 21%) of 523 KT recipients were diagnosed with COVID-19. The mean age of COVID-19 patients was 46.9 ± 13.6, of whom 43% were women. In the multivariate model, body mass index (BMI) ≥ 30 independently increased the risk of COVID-19 incidence with OR 2.00 (95% CI 1.23, 3.26) (P = 0.00), and besides, having diabetes had a marginal association with COVID-19 incidence (OR 1.62 [95% CI 0.98, 2.66]; P = 0.057). The mortality rate of COVID-19 was 15%. In the multivariate model, only pre-transplantation diabetes significantly increased the risk of death by COVID-19 with OR of 3.90 (95% CI 1.00-15.16) (P = 0.04). CONCLUSION Given the higher incidence rate in KT recipients with obesity and diabetes and higher mortality rate in KT recipients with diabetes as the cause of ESRD, more attention should be paid to KT recipients with these risk factors.
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Affiliation(s)
- Hormat Rahimzadeh
- Department of Nephrology Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Khajavi
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Research Center in Emergency and Disaster Health, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Leonardo Oliveira Reis
- UroScience and Department of Surgery (Urology), School of Medical Sciences, University of Campinas, Unicamp and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, São Paulo, Brazil
| | - Fateme Guitynavard
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Dehghani
- Organ Procurement Unit of Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Venus Soleimani
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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SARS-CoV-2 Infection in Kidney Transplant Recipients: A Single-Centre Study of 20 Cases from India. Int J Nephrol 2021; 2021:2243095. [PMID: 34745662 PMCID: PMC8570907 DOI: 10.1155/2021/2243095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/10/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction The second wave of COVID-19 has spread across India causing unprecedented misery to people since March 2021. Kidney transplant recipients (KTRs) are at an increased risk of severe infection. Their outcomes appear to be worse than those in the general population. There is no robust evidence or consensus to support any form of treatment protocol or modification of immunosuppression in KTRs with COVID-19. There is a need to develop effective and safe therapeutic protocols for this frail population. Remdesivir is the only approved antiviral drug in COVID-19 till now. Methods We describe clinical features, role of HRCT, therapeutic protocols, and mortality rate of 20 KTRs with SARS-CoV-2 infection. Results Complete recovery was seen in 8 (40%) patients monitored at home. 12 (60%) patients with HRCT scores more than 8/25 were hospitalized. 11 (55%) had hypoxia, of these 8 (40%) had mild hypoxia, 1 (5%) required NIV, and 2 (10%) needed mechanical ventilation. Immunosuppression was modified in all the patients. Remdesivir and dexamethasone were administered to the hospitalized patients. 1 (5%) patient had AKI requiring RRT. 1 (5%) patient expired, and 1 still hospitalized. 10 of the hospitalized patients recovered. Out of the total 20 patients, 18 (90%) recovered completely within two weeks of infection. Conclusion Clinical presentation of COVID-19 in KTRs was similar to nontransplant patients. Early hospitalisation and assessing the severity by HRCT were important. Continuing tacrolimus and administering remdesivir and dexamethasone reduced the incidence of renal failure and improved survival rates.
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Chen JJ, Kuo G, Lee TH, Yang HY, Wu HH, Tu KH, Tian YC. Incidence of Mortality, Acute Kidney Injury and Graft Loss in Adult Kidney Transplant Recipients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10215162. [PMID: 34768682 PMCID: PMC8584628 DOI: 10.3390/jcm10215162] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 02/07/2023] Open
Abstract
The adverse impact of Coronavirus disease 2019 (COVID-19) on kidney function has been reported since the global pandemic. The burden of COVID-19 on kidney transplant recipients, however, has not been systematically analyzed. A systematic review and meta-analysis with a random-effect model was conducted to explore the rate of mortality, intensive care unit admission, invasive mechanical ventilation, acute kidney injury, kidney replacement therapy and graft loss in the adult kidney transplant population with COVID-19. Sensitivity analysis, subgroup analysis and meta-regression were also performed. Results: we demonstrated a pooled mortality rate of 21% (95% CI: 19−23%), an intensive care unit admission rate of 26% (95% CI: 22–31%), an invasive ventilation rate among those who required intensive care unit care of 72% (95% CI: 62–81%), an acute kidney injury rate of 44% (95% CI: 39–49%), a kidney replacement therapy rate of 12% (95% CI: 9–15%), and a graft loss rate of 8% (95% CI: 5–15%) in kidney transplant recipients with COVID-19. The meta-regression indicated that advancing age is associated with higher mortality; every increase in age by 10 years was associated with an increased mortality rate of 3.7%. Regional differences in outcome were also detected. Further studies focused on treatments and risk factor identification are needed.
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Affiliation(s)
- Jia-Jin Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
| | - George Kuo
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
| | - Tao Han Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
| | - Huang-Yu Yang
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
- Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
| | - Hsin Hsu Wu
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
- Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
| | - Kun-Hua Tu
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
- Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
| | - Ya-Chung Tian
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City 33305, Taiwan; (J.-J.C.); (G.K.); (T.H.L.); (H.-Y.Y.); (H.H.W.); (K.-H.T.)
- Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan
- Correspondence:
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16
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Jasuja S, Sagar G, Bahl A, Verma S. COVID-19 Infection Clinical Profile, Management, Outcome, and Antibody Response in Kidney Transplant Recipients: A Single Centre Experience. Int J Nephrol 2021; 2021:3129411. [PMID: 34616572 PMCID: PMC8490065 DOI: 10.1155/2021/3129411] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 09/13/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Experience of COVID-19 in kidney transplant recipients (KTRs) with clinical presentation, management, factors influencing mortality, and antibody response is limited. Material and Methods. A retrospective data of COVID-19 in KTRs was collected and analyzed. The mortality rate, risk factors, and antibody response were primary objectives, while the clinical presentation, laboratory indicators, and pharmacological management were secondary objectives. RESULTS The 67 KTRs with polymerase chain reaction (PCR) confirmed COVID-19 infection reported between 1 May 2020 and 31 December 2020; 61.2% of patients were hospitalized; and 20.9% needed ventilation. The overall mortality was 26.9%, while blood group A had 50% mortality. The treatment options and used were steroids (100%), convalescent plasma (32.8%), ivermectin (58.2%), doxycycline (55.2%), remdesivir (34.3%), tocilizumab (10.4%), antibiotics (61.2%), anti-fungals (26.9%), low molecular weight heparin (45.3%), and oral anti-coagulants (26.9%). Anti-nucleosides (mycophenolate or azathioprine) were discontinued in 76.1% and calcineurin inhibitors (CNI) in 26.9%. Significant mortality (p < 0.001) was observed in patients presenting with SpO2 <94 needing ICU care, ventilation, dialysis/acute kidney injury (AKI), and empirical therapies like convalescent plasma and remdesivir. The age of survivors versus nonsurvivors was not significantly different (p=0.02). The positive blood culture, low serum albumin, high TLC, high blood urea, interleukin-6, and CT severity score ≥15 were statistically significant in nonsurvivors. Overall mortality, mortality of hospitalized patients, and mortality of ventilated patients was 27%, 44%, and 100%, respectively. The median value of SARS-CoV-2 (COVID-19) IgG antibody was 68.60 (IQR, 28.5-94.25) AU/ml in more than 90% of survivors. CONCLUSION KTRs with COVID-19, needing ICU care, dialysis and ventilation support had poor outcomes. Recovered patients mounted adequate antibody response.
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Affiliation(s)
- Sanjiv Jasuja
- Deaprtment of Nephrology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Gaurav Sagar
- Deaprtment of Nephrology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Anupam Bahl
- Deaprtment of Nephrology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Shalini Verma
- AVATAR Foundation, Department of Clinical Research, New Delhi, India
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17
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Jayant K, Reccia I, Bachul PJ, Al-Salmay Y, Pyda JS, Podda M, Perez-Gutierrez A, Dor FJMF, Becker Y, di Sabato D, LaMattina J, Barth R, Fung J, Witkowski P. The Impact of COVID-19 on Kidney Transplant Recipients in Pre-Vaccination and Delta Strain Era: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:4533. [PMID: 34640552 PMCID: PMC8509345 DOI: 10.3390/jcm10194533] [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: 08/15/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 01/08/2023] Open
Abstract
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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Affiliation(s)
- Kumar Jayant
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Isabella Reccia
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Piotr J. Bachul
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Yaser Al-Salmay
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Jordan S. Pyda
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Mauro Podda
- Department of Emergency Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University Hospital Policlinico Duilio Casula, 09124 Cagliari, Italy;
| | - Angelica Perez-Gutierrez
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Frank J. M. F. Dor
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK;
| | - Yolanda Becker
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Diego di Sabato
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - John LaMattina
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Rolf Barth
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - John Fung
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
| | - Piotr Witkowski
- Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL 60637, USA; (K.J.); (P.J.B.); (Y.A.-S.); (A.P.-G.); (Y.B.); (D.d.S.); (J.L.); (R.B.); (J.F.)
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18
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Nassar M, Nso N, Ariyaratnam J, Sandhu J, Mohamed M, Baraka B, Ibrahim A, Alfishawy M, Zheng D, Bhangoo H, Soliman KM, Li M, Rizzo V, Daoud A. Coronavirus disease 2019 and renal transplantation. World J Clin Cases 2021; 9:7986-7997. [PMID: 34621855 PMCID: PMC8462194 DOI: 10.12998/wjcc.v9.i27.7986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/17/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Ever since the severe acute respiratory syndrome virus causing coronavirus disease 2019 (COVID-19) struck the world, global health strategies have changed significantly. According to the Centers for Disease Control and Prevention, kidney transplant recipients are stratified as being high risk of developing fatal illness from COVID-19 infection. Kidney transplant is the gold-standard treatment for end-stage kidney disease subjects. During the pandemic, significant concerns have emerged regarding continuation of kidney transplant surgeries and management of kidney transplant recipients post-transplant. The added risk of immunosuppression in this cohort was and remains a theoretical concern, posing a potential risk of transplantation rather than benefit. This comprehensive review aims to cover most of the faced challenges in kidney transplantation in different stages of the pandemic. In addition, it will elucidate the epidemiology, nature, course of the disease, surgical consideration in donors and recipients as well as role of immunosuppression and management of COVID-19 infected kidney transplant recipients during these extraordinary circumstances.
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Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Jonathan Ariyaratnam
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Jasmine Sandhu
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Mahmoud Mohamed
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Bahaaeldin Baraka
- Department of Oncology, Southend University Hospital, NHS Foundation Trust, Essex SS0 0RY, United Kingdom
| | - Atif Ibrahim
- Renal Division, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Mostafa Alfishawy
- Infectious Diseases, Infectious Diseases Consultants and Academic Researchers of Egypt IDCARE, Cairo 0000, Egypt
| | - David Zheng
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Harangad Bhangoo
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Karim M Soliman
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Matthew Li
- Department of Clinical Pharmacy, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 10029, United States
| | - Vincent Rizzo
- Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11373, United States
| | - Ahmed Daoud
- Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt
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19
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Tsukada A, Suzuki M, Kishino Y, Misumi K, Igari T, Nakajima N, Sato Y, Suzuki T, Katsuno T, Kusaba Y, Tsujimoto Y, Sakamoto K, Hashimoto M, Terada J, Takasaki J, Izumi S, Hojo M, Sugiyama H. A Kidney Transplant Patient Who Died of COVID-19-associated Severe Acute Respiratory Distress Syndrome. Intern Med 2021; 60:2297-2300. [PMID: 34053986 PMCID: PMC8355385 DOI: 10.2169/internalmedicine.7089-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We herein report a 67-year-old kidney transplant patient who died of COVID-19. He was treated with hydroxychloroquine and azithromycin and received mechanical ventilation that temporarily improved his respiratory status. Despite our efforts, however, he later developed respiratory failure and died 43 days after the disease onset. The autopsy revealed prominent organization of alveoli and alveolar ducts, with a massive accumulation of macrophages in the lungs. A few severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen-positive cells were detected in the lung, suggesting delayed virus clearance owing to his long-term immunosuppressed state, leading to constant lung damage and ultimately respiratory failure.
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Affiliation(s)
- Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yuya Kishino
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Kento Misumi
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Toru Igari
- Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Yuko Sato
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Junko Terada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
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20
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Cacho J, Burgos E, Molina M, Villegas A, Pérez M, Cañas L, Taco O, Juega J, Lauzurica R. [Remdesivir in kidney transplant patients with SARS-CoV-2 pneumonia]. Nefrologia 2021; 42:311-317. [PMID: 34305226 PMCID: PMC8272977 DOI: 10.1016/j.nefro.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
Introducción El remdesivir es el único tratamiento antiviral que ha demostrado ser útil frente al SARS-CoV-2 acortando el tiempo de hospitalización frente a placebo. Su efecto en pacientes trasplantados renales (TR) se limita a algunos casos publicados. Material y métodos Estudio retrospectivo observacional de los pacientes TR que ingresaron entre el 1 de agosto de 2020 hasta el 31 de diciembre de 2020 con neumonía por SARS-CoV-2 y recibieron remdesivir. El objetivo es describir la experiencia de una cohorte de pacientes TR con neumonía por SARS-CoV-2 tratados con remdesivir. Resultados 37 pacientes TR ingresaron por infección secundaria a SARS-CoV-2, 7 de ellos recibieron tratamiento con remdesivir. El resto de pacientes fueron excluidos por CKD-EPI menor a 30 mL/min o por no presentar criterios clínicos. Además de remdesivir, todos recibieron dexametasona y anticoagulación. Cuatro eran hombres, siendo la mediana de edad de 59 (53-71) años. La mediana de tiempo post-trasplante fue de 43 (16-82) meses. Todos los pacientes presentaban neumonía y requirieron oxigenoterapia de bajo flujo al ingreso, precisando en tres de ellos oxigenoterapia de alto flujo durante el ingreso. Dos presentaron deterioro de la función del injerto al diagnóstico, no precisando en ningún caso hemodiálisis, y recuperándose al alta. Dos pacientes elevaron 1,5 veces el valor normal de las transaminasas. Ningún paciente falleció ni precisó ingreso en unidad de críticos. La mediana de días de ingreso fue de 12 (9-27) días. Conclusiones Nuestro estudio sugiere que el uso de remdesivir podría ser útil en los pacientes TR con neumonía por SARS-CoV-2 sin presentar efectos secundarios. Son necesarios más estudios con un mayor número de pacientes para ampliar el conocimiento de este fármaco en la infección por SARS-CoV-2.
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Affiliation(s)
- Judit Cacho
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Elena Burgos
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - María Molina
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Andrés Villegas
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Mónica Pérez
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Laura Cañas
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Omar Taco
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Javier Juega
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - Ricardo Lauzurica
- Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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21
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Shaikh N, Khatib MY, Alwraidat MA, Ananthegowda DC, Othman M, Aroos A, Jujjavarapu SB, Banerjee S, Nasir Z, Mohamed AS, Elshafei MS, Almaslamani MA, Nashwan AJ. Clinical outcomes of post-renal transplant patients with COVID-19 infection in the ICU: A single-center case series. Clin Case Rep 2021; 9:e04513. [PMID: 34322259 PMCID: PMC8299096 DOI: 10.1002/ccr3.4513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 12/21/2022] Open
Abstract
Most of the post-renal transplant patients are taking immunosuppressive medications, including calcineurin inhibitors, anti-proliferative agents, and steroids. This case series highlights the clinical characteristics and outcomes of eight post-renal transplant patients with severe COVID-19 infection admitted to the intensive care unit.
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Affiliation(s)
- Nissar Shaikh
- Surgical Intensive Care DepartmentHamad General Hospital (HGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Mohamad Y. Khatib
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Mohammad A. Alwraidat
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Dore C. Ananthegowda
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Muftah Othman
- Nephrology DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Asra Aroos
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Sagar B. Jujjavarapu
- Nephrology DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Saptarshi Banerjee
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Zishan Nasir
- Nephrology DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Ahmed S. Mohamed
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | - Moustafa S. Elshafei
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
| | | | - Abdulqadir J. Nashwan
- Medical Intensive Care DepartmentHazm Mebaireek General Hospital (HMGH)Hamad Medical Corporation (HMC)DohaQatar
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22
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Therapeutic strategy of pregnancy associated with renal transplant and SARS-CoV-2 infection – case report. GINECOLOGIA.RO 2021. [DOI: 10.26416/gine.33.3.2021.5307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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