COVID‐19 in solid organ transplant recipients: Initial report from the US epicenter

Solid organ transplant recipients may be at a high risk for SARS‐CoV‐2 infection and poor associated outcomes. We herein report our initial experience with solid organ transplant recipients with SARS‐CoV‐2 infection at two centers during the first 3 weeks of the outbreak in New York City. Baseline c...

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Podrobná bibliografie
Vydáno v:	American journal of transplantation Ročník 20; číslo 7; s. 1800 - 1808
Hlavní autoři:	Pereira, Marcus R., Mohan, Sumit, Cohen, David J., Husain, Syed A., Dube, Geoffrey K., Ratner, Lloyd E., Arcasoy, Selim, Aversa, Meghan M., Benvenuto, Luke J., Dadhania, Darshana M., Kapur, Sandip, Dove, Lorna M., Brown, Robert S., Rosenblatt, Russell E., Samstein, Benjamin, Uriel, Nir, Farr, Maryjane A., Satlin, Michael, Small, Catherine B., Walsh, Thomas J., Kodiyanplakkal, Rosy P., Miko, Benjamin A., Aaron, Justin G., Tsapepas, Demetra S., Emond, Jean C., Verna, Elizabeth C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Elsevier Limited 01.07.2020 John Wiley and Sons Inc
Témata:	Adenosine Monophosphate - analogs & derivatives Adenosine Monophosphate - therapeutic use Adult Aged Alanine - analogs & derivatives Alanine - therapeutic use antibiotic: antiviral Antibiotics Antibodies, Monoclonal, Humanized - therapeutic use Antiviral Agents - therapeutic use Antiviral drugs Asymptomatic Azithromycin Azithromycin - therapeutic use Betacoronavirus clinical research/practice complication: infectious Coronavirus Infections - complications Coronavirus Infections - drug therapy Coronavirus Infections - epidemiology Coronavirus Infections - mortality Cough COVID-19 COVID-19 Drug Treatment Critical Care Dyspnea Female Fever Health risk assessment Heart transplantation Hospitalization Humans Hydroxychloroquine Hydroxychloroquine - therapeutic use Immunomodulators Immunosuppression Therapy immunosuppression/immune modulation Immunosuppressive Agents - therapeutic use infection and infectious agents – viral infectious disease Intensive Care Units Intubation Male Middle Aged Monoclonal antibodies New York City - epidemiology Organ Transplantation - adverse effects organ transplantation in general Original ORIGINAL ARTICLES Outbreaks Pandemics Pneumonia, Viral - complications Pneumonia, Viral - epidemiology Pneumonia, Viral - mortality Respiration Respiration, Artificial SARS-CoV-2 Steroid hormones Steroids - therapeutic use Transplant Recipients Transplants & implants Treatment Outcome United States New York City United States immunosuppression/immune modulation infectious disease organ transplantation in general clinical research/practice infection and infectious agents - viral complication: infectious antibiotic: antiviral
ISSN:	1600-6135, 1600-6143, 1600-6143
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Popis
Shrnutí:	Solid organ transplant recipients may be at a high risk for SARS‐CoV‐2 infection and poor associated outcomes. We herein report our initial experience with solid organ transplant recipients with SARS‐CoV‐2 infection at two centers during the first 3 weeks of the outbreak in New York City. Baseline characteristics, clinical presentation, antiviral and immunosuppressive management were compared between patients with mild/moderate and severe disease (defined as ICU admission, intubation or death). Ninety patients were analyzed with a median age of 57 years. Forty‐six were kidney recipients, 17 lung, 13 liver, 9 heart, and 5 dual‐organ transplants. The most common presenting symptoms were fever (70%), cough (59%), and dyspnea (43%). Twenty‐two (24%) had mild, 41 (46%) moderate, and 27 (30%) severe disease. Among the 68 hospitalized patients, 12% required non‐rebreather and 35% required intubation. 91% received hydroxychloroquine, 66% azithromycin, 3% remdesivir, 21% tocilizumab, and 24% bolus steroids. Sixteen patients died (18% overall, 24% of hospitalized, 52% of ICU) and 37 (54%) were discharged. In this initial cohort, transplant recipients with COVID‐19 appear to have more severe outcomes, although testing limitations likely led to undercounting of mild/asymptomatic cases. As this outbreak unfolds, COVID‐19 has the potential to severely impact solid organ transplant recipients. In this multicenter study of 90 solid organ transplant recipients diagnosed with COVID‐19 during the first three weeks of the outbreak in New York City, the authors report on the clinical presentation, laboratory abnormalities, risk factors, disease severity, and outcomes.
Bibliografie:	Funding information SAH is supported by the NCATS (KL2 TR001874). SM is supported by NIDDK (R01 DK114893 and U01 DK116066) and NIMHD (R01 MD14161). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1600-6135 1600-6143 1600-6143
DOI:	10.1111/ajt.15941