COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity.
Identifieur interne : 000453 ( Main/Corpus ); précédent : 000452; suivant : 000454COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity.
Auteurs : K. Sran ; J. Olsburgh ; T. Kasimatis ; K. Clark ; R. Gökmen ; R. Hilton ; S. Shah ; C. Shaw ; C. Farmer ; H. Kilbride ; E. AsgariSource :
- Transplantation proceedings [ 1873-2623 ] ; 2020.
Abstract
BACKGROUND
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients.
METHODS
Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test.
RESULTS
Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored.
CONCLUSIONS
Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.
DOI: 10.1016/j.transproceed.2020.11.007
PubMed: 33483166
PubMed Central: PMC7833961
Links to Exploration step
pubmed:33483166Le document en format XML
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Kasimatis</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Clark, K" sort="Clark, K" uniqKey="Clark K" first="K" last="Clark">K. Clark</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Gokmen, R" sort="Gokmen, R" uniqKey="Gokmen R" first="R" last="Gökmen">R. Gökmen</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Hilton, R" sort="Hilton, R" uniqKey="Hilton R" first="R" last="Hilton">R. Hilton</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, S" sort="Shah, S" uniqKey="Shah S" first="S" last="Shah">S. Shah</name><affiliation><nlm:affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Shaw, C" sort="Shaw, C" uniqKey="Shaw C" first="C" last="Shaw">C. Shaw</name><affiliation><nlm:affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Farmer, C" sort="Farmer, C" uniqKey="Farmer C" first="C" last="Farmer">C. Farmer</name><affiliation><nlm:affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Kilbride, H" sort="Kilbride, H" uniqKey="Kilbride H" first="H" last="Kilbride">H. Kilbride</name><affiliation><nlm:affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Asgari, E" sort="Asgari, E" uniqKey="Asgari E" first="E" last="Asgari">E. Asgari</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33483166</idno><idno type="pmid">33483166</idno><idno type="doi">10.1016/j.transproceed.2020.11.007</idno><idno type="pmc">PMC7833961</idno><idno type="wicri:Area/Main/Corpus">000453</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000453</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity.</title><author><name sortKey="Sran, K" sort="Sran, K" uniqKey="Sran K" first="K" last="Sran">K. Sran</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address: Kiran.sran@gstt.nhs.uk.</nlm:affiliation></affiliation></author><author><name sortKey="Olsburgh, J" sort="Olsburgh, J" uniqKey="Olsburgh J" first="J" last="Olsburgh">J. Olsburgh</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Kasimatis, T" sort="Kasimatis, T" uniqKey="Kasimatis T" first="T" last="Kasimatis">T. Kasimatis</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Clark, K" sort="Clark, K" uniqKey="Clark K" first="K" last="Clark">K. Clark</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Gokmen, R" sort="Gokmen, R" uniqKey="Gokmen R" first="R" last="Gökmen">R. Gökmen</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Hilton, R" sort="Hilton, R" uniqKey="Hilton R" first="R" last="Hilton">R. Hilton</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Shah, S" sort="Shah, S" uniqKey="Shah S" first="S" last="Shah">S. Shah</name><affiliation><nlm:affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Shaw, C" sort="Shaw, C" uniqKey="Shaw C" first="C" last="Shaw">C. Shaw</name><affiliation><nlm:affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Farmer, C" sort="Farmer, C" uniqKey="Farmer C" first="C" last="Farmer">C. Farmer</name><affiliation><nlm:affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Kilbride, H" sort="Kilbride, H" uniqKey="Kilbride H" first="H" last="Kilbride">H. Kilbride</name><affiliation><nlm:affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Asgari, E" sort="Asgari, E" uniqKey="Asgari E" first="E" last="Asgari">E. Asgari</name><affiliation><nlm:affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Transplantation proceedings</title><idno type="eISSN">1873-2623</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33483166</PMID><DateRevised><Year>2021</Year><Month>03</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-2623</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Dec</Month><Day>17</Day></PubDate></JournalIssue><Title>Transplantation proceedings</Title><ISOAbbreviation>Transplant Proc</ISOAbbreviation></Journal><ArticleTitle>COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0041-1345(20)32901-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.transproceed.2020.11.007</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sran</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address: Kiran.sran@gstt.nhs.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Olsburgh</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kasimatis</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clark</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gökmen</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hilton</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shaw</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Renal Unit, King's College Hospital NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Farmer</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kilbride</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Asgari</LastName><ForeName>E</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Transplant Proc</MedlineTA><NlmUniqueID>0243532</NlmUniqueID><ISSNLinking>0041-1345</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>10</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>11</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>11</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>23</Day><Hour>5</Hour><Minute>31</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33483166</ArticleId><ArticleId IdType="pii">S0041-1345(20)32901-8</ArticleId><ArticleId IdType="doi">10.1016/j.transproceed.2020.11.007</ArticleId><ArticleId IdType="pmc">PMC7833961</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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