RapamycinFungusV1, Main, Exploration, bibRecord, 000000

COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.

Identifieur interne : 000000 ( Main/Exploration ); suivant : 000001

COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.

Auteurs : Arnaud Devresse [Belgique] ; Leila Belkhir [Belgique] ; Bernard Vo [Belgique] ; Benoit Ghaye [Belgique] ; Anaïs Scohy [Belgique] ; Benoit Kabamba [Belgique] ; Eric Goffin [Belgique] ; Julien De Greef [Belgique] ; Michel Mourad [Belgique] ; Martine De Meyer [Belgique] ; Jean-Cyr Yombi [Belgique] ; Nada Kanaan [Belgique]

Source :

Kidney medicine [ 2590-0595 ]

RBID : pubmed:32775986

Abstract

Rationale & Objective

The world is facing a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although kidney transplant recipients are at increased risk for viral infections, the impact of their chronic immunosuppressed status on the risk for acquiring coronavirus disease 2019 (COVID-19) and disease severity is unknown.

Study Design

All cases of COVID-19 infection in our cohort of kidney transplant recipients were prospectively monitored. Clinical features, management, and outcomes were recorded. A standard strategy of immunosuppression minimization was applied: discontinue the antimetabolite drug and reduce trough levels of calcineurin or mammalian target of rapamycin inhibitors. Unless contraindicated, hydroxychloroquine was administered only to hospitalized patients.

Setting & Participants

22 COVID-19 infections were diagnosed in our cohort of 1,200 kidney transplant recipients.

Results

Most common initial symptoms included fever, cough, or dyspnea. 18 (82%) patients required hospitalization. Of those patients, 3 had everolimus-based immunosuppression. Computed tomography of the chest at admission (performed in 15 patients) showed mild (n = 3), moderate (n = 8), extensive (n = 1), severe (n = 2), and critical (n = 1) involvement. Immunosuppression reduction was initiated in all patients. Hydroxychloroquine was administered to 15 patients. 11 patients required supplemental oxygen; 2 of them were admitted to an intensive care unit (ICU) with mechanical ventilation. After a median of 10 days, 13 kidney transplant recipients were discharged, 2 were hospitalized in non-ICU units, 1 was in the ICU, and 2 patients had died.

Limitations

Small sample size and short follow-up.

Conclusions

The clinical presentation of COVID-19 infection was similar to that reported in the general population. A standard strategy of immunosuppression minimization and treatment was applied, with 11% mortality among kidney transplant recipients hospitalized with COVID-19 infection.

DOI: 10.1016/j.xkme.2020.06.001
PubMed: 32775986
PubMed Central: PMC7295531

Affiliations:

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<author><name sortKey="Kanaan, Nada" sort="Kanaan, Nada" uniqKey="Kanaan N" first="Nada" last="Kanaan">Nada Kanaan</name>
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<front><div type="abstract" xml:lang="en"><p><b>Rationale & Objective</b>
</p>
<p>The world is facing a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although kidney transplant recipients are at increased risk for viral infections, the impact of their chronic immunosuppressed status on the risk for acquiring coronavirus disease 2019 (COVID-19) and disease severity is unknown.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Study Design</b>
</p>
<p>All cases of COVID-19 infection in our cohort of kidney transplant recipients were prospectively monitored. Clinical features, management, and outcomes were recorded. A standard strategy of immunosuppression minimization was applied: discontinue the antimetabolite drug and reduce trough levels of calcineurin or mammalian target of rapamycin inhibitors. Unless contraindicated, hydroxychloroquine was administered only to hospitalized patients.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Setting & Participants</b>
</p>
<p>22 COVID-19 infections were diagnosed in our cohort of 1,200 kidney transplant recipients.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Results</b>
</p>
<p>Most common initial symptoms included fever, cough, or dyspnea. 18 (82%) patients required hospitalization. Of those patients, 3 had everolimus-based immunosuppression. Computed tomography of the chest at admission (performed in 15 patients) showed mild (n = 3), moderate (n = 8), extensive (n = 1), severe (n = 2), and critical (n = 1) involvement. Immunosuppression reduction was initiated in all patients. Hydroxychloroquine was administered to 15 patients. 11 patients required supplemental oxygen; 2 of them were admitted to an intensive care unit (ICU) with mechanical ventilation. After a median of 10 days, 13 kidney transplant recipients were discharged, 2 were hospitalized in non-ICU units, 1 was in the ICU, and 2 patients had died.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Limitations</b>
</p>
<p>Small sample size and short follow-up.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusions</b>
</p>
<p>The clinical presentation of COVID-19 infection was similar to that reported in the general population. A standard strategy of immunosuppression minimization and treatment was applied, with 11% mortality among kidney transplant recipients hospitalized with COVID-19 infection.</p>
</div>
</front>
</TEI>
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<DateRevised><Year>2020</Year>
<Month>09</Month>
<Day>28</Day>
</DateRevised>
<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">2590-0595</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>2</Volume>
<Issue>4</Issue>
<PubDate><MedlineDate>2020 Jul-Aug</MedlineDate>
</PubDate>
</JournalIssue>
<Title>Kidney medicine</Title>
<ISOAbbreviation>Kidney Med</ISOAbbreviation>
</Journal>
<ArticleTitle>COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.</ArticleTitle>
<Pagination><MedlinePgn>459-466</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.xkme.2020.06.001</ELocationID>
<Abstract><AbstractText Label="Rationale & Objective" NlmCategory="UNASSIGNED">The world is facing a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although kidney transplant recipients are at increased risk for viral infections, the impact of their chronic immunosuppressed status on the risk for acquiring coronavirus disease 2019 (COVID-19) and disease severity is unknown.</AbstractText>
<AbstractText Label="Study Design" NlmCategory="UNASSIGNED">All cases of COVID-19 infection in our cohort of kidney transplant recipients were prospectively monitored. Clinical features, management, and outcomes were recorded. A standard strategy of immunosuppression minimization was applied: discontinue the antimetabolite drug and reduce trough levels of calcineurin or mammalian target of rapamycin inhibitors. Unless contraindicated, hydroxychloroquine was administered only to hospitalized patients.</AbstractText>
<AbstractText Label="Setting & Participants" NlmCategory="UNASSIGNED">22 COVID-19 infections were diagnosed in our cohort of 1,200 kidney transplant recipients.</AbstractText>
<AbstractText Label="Results" NlmCategory="UNASSIGNED">Most common initial symptoms included fever, cough, or dyspnea. 18 (82%) patients required hospitalization. Of those patients, 3 had everolimus-based immunosuppression. Computed tomography of the chest at admission (performed in 15 patients) showed mild (n = 3), moderate (n = 8), extensive (n = 1), severe (n = 2), and critical (n = 1) involvement. Immunosuppression reduction was initiated in all patients. Hydroxychloroquine was administered to 15 patients. 11 patients required supplemental oxygen; 2 of them were admitted to an intensive care unit (ICU) with mechanical ventilation. After a median of 10 days, 13 kidney transplant recipients were discharged, 2 were hospitalized in non-ICU units, 1 was in the ICU, and 2 patients had died.</AbstractText>
<AbstractText Label="Limitations" NlmCategory="UNASSIGNED">Small sample size and short follow-up.</AbstractText>
<AbstractText Label="Conclusions" NlmCategory="UNASSIGNED">The clinical presentation of COVID-19 infection was similar to that reported in the general population. A standard strategy of immunosuppression minimization and treatment was applied, with 11% mortality among kidney transplant recipients hospitalized with COVID-19 infection.</AbstractText>
<CopyrightInformation>© 2020 The Authors.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Devresse</LastName>
<ForeName>Arnaud</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Belkhir</LastName>
<ForeName>Leila</ForeName>
<Initials>L</Initials>
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COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.

COVID-19 Infection in Kidney Transplant Recipients: A Single-Center Case Series of 22 Cases From Belgium.

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