COVID-19 in transplant recipients: The Spanish experience.
Identifieur interne : 000954 ( Main/Corpus ); précédent : 000953; suivant : 000955COVID-19 in transplant recipients: The Spanish experience.
Auteurs : Elisabeth Coll ; Mario Fernández-Ruiz ; J Emilio Sánchez-Álvarez ; José R. Martínez-Fernández ; Marta Crespo ; Jorge Gayoso ; Teresa Bada-Bosch ; Federico Oppenheimer ; Francesc Moreso ; María O. L Pez-Oliva ; Edoardo Melilli ; Marisa L. Rodríguez-Ferrero ; Carlos Bravo ; Elena Burgos ; Carme Facundo ; Inmaculada Lorenzo ; Í Igo Ya Ez ; Cristina Galeano ; Ana Roca ; Mercedes Cabello ; Manuel G Mez-Bueno ; M Dolores García-Cosío ; Javier Graus ; Laura Llad ; Alicia De Pablo ; Carmelo Loinaz ; Beatriz Aguado ; Domingo Hernández ; Beatriz Domínguez-GilSource :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [ 1600-6143 ] ; 2021.
English descriptors
- KwdEn :
- MESH :
- geographic , epidemiology : Spain.
- epidemiology : COVID-19.
- mortality : COVID-19.
- Female, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Organ Transplantation, SARS-CoV-2, Transplant Recipients.
Abstract
We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).
DOI: 10.1111/ajt.16369
PubMed: 33098200
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pubmed:33098200Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 in transplant recipients: The Spanish experience.</title><author><name sortKey="Coll, Elisabeth" sort="Coll, Elisabeth" uniqKey="Coll E" first="Elisabeth" last="Coll">Elisabeth Coll</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Fernandez Ruiz, Mario" sort="Fernandez Ruiz, Mario" uniqKey="Fernandez Ruiz M" first="Mario" last="Fernández-Ruiz">Mario Fernández-Ruiz</name><affiliation><nlm:affiliation>Unit of Infectious Diseases, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria, Hospital Universitario 12 de Octubre (imas12), President of the Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Sanchez Lvarez, J Emilio" sort="Sanchez Lvarez, J Emilio" uniqKey="Sanchez Lvarez J" first="J Emilio" last="Sánchez-Álvarez">J Emilio Sánchez-Álvarez</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Spanish Society of Nephrology (SEN), Gijón, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Martinez Fernandez, Jose R" sort="Martinez Fernandez, Jose R" uniqKey="Martinez Fernandez J" first="José R" last="Martínez-Fernández">José R. Martínez-Fernández</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Crespo, Marta" sort="Crespo, Marta" uniqKey="Crespo M" first="Marta" last="Crespo">Marta Crespo</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital del Mar, Barcelona, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Transplant Working Group of the Spanish Society of Nephrology (SEN), Barcelona, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>REDinREN (RD16/0009/0013), Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Gayoso, Jorge" sort="Gayoso, Jorge" uniqKey="Gayoso J" first="Jorge" last="Gayoso">Jorge Gayoso</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Bada Bosch, Teresa" sort="Bada Bosch, Teresa" uniqKey="Bada Bosch T" first="Teresa" last="Bada-Bosch">Teresa Bada-Bosch</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Oppenheimer, Federico" sort="Oppenheimer, Federico" uniqKey="Oppenheimer F" first="Federico" last="Oppenheimer">Federico Oppenheimer</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Clinic, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Moreso, Francesc" sort="Moreso, Francesc" uniqKey="Moreso F" first="Francesc" last="Moreso">Francesc Moreso</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="L Pez Oliva, Maria O" sort="L Pez Oliva, Maria O" uniqKey="L Pez Oliva M" first="María O" last="L Pez-Oliva">María O. L Pez-Oliva</name><affiliation><nlm:affiliation>Department oof Nephrology, Hospital Universitario La Paz, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Melilli, Edoardo" sort="Melilli, Edoardo" uniqKey="Melilli E" first="Edoardo" last="Melilli">Edoardo Melilli</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Rodriguez Ferrero, Marisa L" sort="Rodriguez Ferrero, Marisa L" uniqKey="Rodriguez Ferrero M" first="Marisa L" last="Rodríguez-Ferrero">Marisa L. Rodríguez-Ferrero</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Bravo, Carlos" sort="Bravo, Carlos" uniqKey="Bravo C" first="Carlos" last="Bravo">Carlos Bravo</name><affiliation><nlm:affiliation>Department of Pulmonology, Lung transplant Unit, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Burgos, Elena" sort="Burgos, Elena" uniqKey="Burgos E" first="Elena" last="Burgos">Elena Burgos</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Facundo, Carme" sort="Facundo, Carme" uniqKey="Facundo C" first="Carme" last="Facundo">Carme Facundo</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Fundación Puigvert, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lorenzo, Inmaculada" sort="Lorenzo, Inmaculada" uniqKey="Lorenzo I" first="Inmaculada" last="Lorenzo">Inmaculada Lorenzo</name><affiliation><nlm:affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Ya Ez, I Igo" sort="Ya Ez, I Igo" uniqKey="Ya Ez I" first="Í Igo" last="Ya Ez">Í Igo Ya Ez</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario de Cruces, Barakaldo, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Galeano, Cristina" sort="Galeano, Cristina" uniqKey="Galeano C" first="Cristina" last="Galeano">Cristina Galeano</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Roca, Ana" sort="Roca, Ana" uniqKey="Roca A" first="Ana" last="Roca">Ana Roca</name><affiliation><nlm:affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Cabello, Mercedes" sort="Cabello, Mercedes" uniqKey="Cabello M" first="Mercedes" last="Cabello">Mercedes Cabello</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Regional Universitario de Málaga, Málaga, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="G Mez Bueno, Manuel" sort="G Mez Bueno, Manuel" uniqKey="G Mez Bueno M" first="Manuel" last="G Mez-Bueno">Manuel G Mez-Bueno</name><affiliation><nlm:affiliation>Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Garcia Cosio, M Dolores" sort="Garcia Cosio, M Dolores" uniqKey="Garcia Cosio M" first="M Dolores" last="García-Cosío">M Dolores García-Cosío</name><affiliation><nlm:affiliation>Cardiology Service, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Graus, Javier" sort="Graus, Javier" uniqKey="Graus J" first="Javier" last="Graus">Javier Graus</name><affiliation><nlm:affiliation>Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Llad, Laura" sort="Llad, Laura" uniqKey="Llad L" first="Laura" last="Llad">Laura Llad</name><affiliation><nlm:affiliation>Liver Transplant Unit, Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="De Pablo, Alicia" sort="De Pablo, Alicia" uniqKey="De Pablo A" first="Alicia" last="De Pablo">Alicia De Pablo</name><affiliation><nlm:affiliation>Lung Transplant Unit, Department of Pneumology, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Loinaz, Carmelo" sort="Loinaz, Carmelo" uniqKey="Loinaz C" first="Carmelo" last="Loinaz">Carmelo Loinaz</name><affiliation><nlm:affiliation>Transplant Unit, Department of General Surgery, Digestive Tract and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Aguado, Beatriz" sort="Aguado, Beatriz" uniqKey="Aguado B" first="Beatriz" last="Aguado">Beatriz Aguado</name><affiliation><nlm:affiliation>Transplant Unit. Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Hernandez, Domingo" sort="Hernandez, Domingo" uniqKey="Hernandez D" first="Domingo" last="Hernández">Domingo Hernández</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Regional Universitario, Málaga, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Spanish Society of Transplantation (SET), Málaga, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Dominguez Gil, Beatriz" sort="Dominguez Gil, Beatriz" uniqKey="Dominguez Gil B" first="Beatriz" last="Domínguez-Gil">Beatriz Domínguez-Gil</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33098200</idno><idno type="pmid">33098200</idno><idno type="doi">10.1111/ajt.16369</idno><idno type="wicri:Area/Main/Corpus">000954</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000954</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 in transplant recipients: The Spanish experience.</title><author><name sortKey="Coll, Elisabeth" sort="Coll, Elisabeth" uniqKey="Coll E" first="Elisabeth" last="Coll">Elisabeth Coll</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Fernandez Ruiz, Mario" sort="Fernandez Ruiz, Mario" uniqKey="Fernandez Ruiz M" first="Mario" last="Fernández-Ruiz">Mario Fernández-Ruiz</name><affiliation><nlm:affiliation>Unit of Infectious Diseases, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria, Hospital Universitario 12 de Octubre (imas12), President of the Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Sanchez Lvarez, J Emilio" sort="Sanchez Lvarez, J Emilio" uniqKey="Sanchez Lvarez J" first="J Emilio" last="Sánchez-Álvarez">J Emilio Sánchez-Álvarez</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Spanish Society of Nephrology (SEN), Gijón, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Martinez Fernandez, Jose R" sort="Martinez Fernandez, Jose R" uniqKey="Martinez Fernandez J" first="José R" last="Martínez-Fernández">José R. Martínez-Fernández</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Crespo, Marta" sort="Crespo, Marta" uniqKey="Crespo M" first="Marta" last="Crespo">Marta Crespo</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital del Mar, Barcelona, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Transplant Working Group of the Spanish Society of Nephrology (SEN), Barcelona, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>REDinREN (RD16/0009/0013), Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Gayoso, Jorge" sort="Gayoso, Jorge" uniqKey="Gayoso J" first="Jorge" last="Gayoso">Jorge Gayoso</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Bada Bosch, Teresa" sort="Bada Bosch, Teresa" uniqKey="Bada Bosch T" first="Teresa" last="Bada-Bosch">Teresa Bada-Bosch</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Oppenheimer, Federico" sort="Oppenheimer, Federico" uniqKey="Oppenheimer F" first="Federico" last="Oppenheimer">Federico Oppenheimer</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Clinic, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Moreso, Francesc" sort="Moreso, Francesc" uniqKey="Moreso F" first="Francesc" last="Moreso">Francesc Moreso</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="L Pez Oliva, Maria O" sort="L Pez Oliva, Maria O" uniqKey="L Pez Oliva M" first="María O" last="L Pez-Oliva">María O. L Pez-Oliva</name><affiliation><nlm:affiliation>Department oof Nephrology, Hospital Universitario La Paz, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Melilli, Edoardo" sort="Melilli, Edoardo" uniqKey="Melilli E" first="Edoardo" last="Melilli">Edoardo Melilli</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Rodriguez Ferrero, Marisa L" sort="Rodriguez Ferrero, Marisa L" uniqKey="Rodriguez Ferrero M" first="Marisa L" last="Rodríguez-Ferrero">Marisa L. Rodríguez-Ferrero</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Bravo, Carlos" sort="Bravo, Carlos" uniqKey="Bravo C" first="Carlos" last="Bravo">Carlos Bravo</name><affiliation><nlm:affiliation>Department of Pulmonology, Lung transplant Unit, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Burgos, Elena" sort="Burgos, Elena" uniqKey="Burgos E" first="Elena" last="Burgos">Elena Burgos</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Germans Trias i Pujol, Badalona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Facundo, Carme" sort="Facundo, Carme" uniqKey="Facundo C" first="Carme" last="Facundo">Carme Facundo</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Fundación Puigvert, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Lorenzo, Inmaculada" sort="Lorenzo, Inmaculada" uniqKey="Lorenzo I" first="Inmaculada" last="Lorenzo">Inmaculada Lorenzo</name><affiliation><nlm:affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Ya Ez, I Igo" sort="Ya Ez, I Igo" uniqKey="Ya Ez I" first="Í Igo" last="Ya Ez">Í Igo Ya Ez</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Universitario de Cruces, Barakaldo, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Galeano, Cristina" sort="Galeano, Cristina" uniqKey="Galeano C" first="Cristina" last="Galeano">Cristina Galeano</name><affiliation><nlm:affiliation>Kidney Transplant Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Roca, Ana" sort="Roca, Ana" uniqKey="Roca A" first="Ana" last="Roca">Ana Roca</name><affiliation><nlm:affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Cabello, Mercedes" sort="Cabello, Mercedes" uniqKey="Cabello M" first="Mercedes" last="Cabello">Mercedes Cabello</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Regional Universitario de Málaga, Málaga, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="G Mez Bueno, Manuel" sort="G Mez Bueno, Manuel" uniqKey="G Mez Bueno M" first="Manuel" last="G Mez-Bueno">Manuel G Mez-Bueno</name><affiliation><nlm:affiliation>Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Garcia Cosio, M Dolores" sort="Garcia Cosio, M Dolores" uniqKey="Garcia Cosio M" first="M Dolores" last="García-Cosío">M Dolores García-Cosío</name><affiliation><nlm:affiliation>Cardiology Service, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Graus, Javier" sort="Graus, Javier" uniqKey="Graus J" first="Javier" last="Graus">Javier Graus</name><affiliation><nlm:affiliation>Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Llad, Laura" sort="Llad, Laura" uniqKey="Llad L" first="Laura" last="Llad">Laura Llad</name><affiliation><nlm:affiliation>Liver Transplant Unit, Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="De Pablo, Alicia" sort="De Pablo, Alicia" uniqKey="De Pablo A" first="Alicia" last="De Pablo">Alicia De Pablo</name><affiliation><nlm:affiliation>Lung Transplant Unit, Department of Pneumology, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Loinaz, Carmelo" sort="Loinaz, Carmelo" uniqKey="Loinaz C" first="Carmelo" last="Loinaz">Carmelo Loinaz</name><affiliation><nlm:affiliation>Transplant Unit, Department of General Surgery, Digestive Tract and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Aguado, Beatriz" sort="Aguado, Beatriz" uniqKey="Aguado B" first="Beatriz" last="Aguado">Beatriz Aguado</name><affiliation><nlm:affiliation>Transplant Unit. Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Hernandez, Domingo" sort="Hernandez, Domingo" uniqKey="Hernandez D" first="Domingo" last="Hernández">Domingo Hernández</name><affiliation><nlm:affiliation>Department of Nephrology, Hospital Regional Universitario, Málaga, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Spanish Society of Transplantation (SET), Málaga, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Dominguez Gil, Beatriz" sort="Dominguez Gil, Beatriz" uniqKey="Dominguez Gil B" first="Beatriz" last="Domínguez-Gil">Beatriz Domínguez-Gil</name><affiliation><nlm:affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</nlm:affiliation></affiliation></author></analytic><series><title level="j">American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons</title><idno type="eISSN">1600-6143</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (epidemiology)</term><term>COVID-19 (mortality)</term><term>Female (MeSH)</term><term>Hematopoietic Stem Cell Transplantation (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Organ Transplantation (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Spain (epidemiology)</term><term>Transplant Recipients (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Hematopoietic Stem Cell Transplantation</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Organ Transplantation</term><term>SARS-CoV-2</term><term>Transplant Recipients</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">33098200</PMID><DateCompleted><Year>2021</Year><Month>05</Month><Day>13</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1600-6143</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>5</Issue><PubDate><Year>2021</Year><Month>05</Month></PubDate></JournalIssue><Title>American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons</Title><ISOAbbreviation>Am J Transplant</ISOAbbreviation></Journal><ArticleTitle>COVID-19 in transplant recipients: The Spanish experience.</ArticleTitle><Pagination><MedlinePgn>1825-1837</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/ajt.16369</ELocationID><Abstract><AbstractText>We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).</AbstractText><CopyrightInformation>© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Coll</LastName><ForeName>Elisabeth</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fernández-Ruiz</LastName><ForeName>Mario</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-0315-8001</Identifier><AffiliationInfo><Affiliation>Unit of Infectious Diseases, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria, Hospital Universitario 12 de Octubre (imas12), President of the Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sánchez-Álvarez</LastName><ForeName>J Emilio</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Spanish Society of Nephrology (SEN), Gijón, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martínez-Fernández</LastName><ForeName>José R</ForeName><Initials>JR</Initials><AffiliationInfo><Affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crespo</LastName><ForeName>Marta</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0001-6992-6379</Identifier><AffiliationInfo><Affiliation>Department of Nephrology, Hospital del Mar, Barcelona, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Transplant Working Group of the Spanish Society of Nephrology (SEN), Barcelona, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>REDinREN (RD16/0009/0013), Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gayoso</LastName><ForeName>Jorge</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bada-Bosch</LastName><ForeName>Teresa</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oppenheimer</LastName><ForeName>Federico</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Clinic, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moreso</LastName><ForeName>Francesc</ForeName><Initials>F</Initials><Identifier Source="ORCID">0000-0002-7267-3963</Identifier><AffiliationInfo><Affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>López-Oliva</LastName><ForeName>María O</ForeName><Initials>MO</Initials><Identifier Source="ORCID">0000-0003-3503-3518</Identifier><AffiliationInfo><Affiliation>Department oof Nephrology, Hospital Universitario La Paz, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Melilli</LastName><ForeName>Edoardo</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0001-6965-3745</Identifier><AffiliationInfo><Affiliation>Kidney Transplant Unit, Department of Nephrology, Hospital Universitario de Bellvitge, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodríguez-Ferrero</LastName><ForeName>Marisa L</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bravo</LastName><ForeName>Carlos</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Pulmonology, Lung transplant Unit, Hospital Universitario Vall d´Hebrón, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Burgos</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Germans Trias i Pujol, Badalona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Facundo</LastName><ForeName>Carme</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Kidney Transplant Unit, Fundación Puigvert, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lorenzo</LastName><ForeName>Inmaculada</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yañez</LastName><ForeName>Íñigo</ForeName><Initials>Í</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario de Cruces, Barakaldo, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Galeano</LastName><ForeName>Cristina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Kidney Transplant Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roca</LastName><ForeName>Ana</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cabello</LastName><ForeName>Mercedes</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Regional Universitario de Málaga, Málaga, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gómez-Bueno</LastName><ForeName>Manuel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>García-Cosío</LastName><ForeName>MªDolores</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Cardiology Service, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Graus</LastName><ForeName>Javier</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Hospital Universitario Ramón y Cajal, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lladó</LastName><ForeName>Laura</ForeName><Initials>L</Initials><Identifier Source="ORCID">0000-0002-3717-3306</Identifier><AffiliationInfo><Affiliation>Liver Transplant Unit, Hospital Universitario de Bellvitge, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Pablo</LastName><ForeName>Alicia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Lung Transplant Unit, Department of Pneumology, Hospital Universitario 12 de Octubre, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loinaz</LastName><ForeName>Carmelo</ForeName><Initials>C</Initials><Identifier Source="ORCID">0000-0002-1873-0568</Identifier><AffiliationInfo><Affiliation>Transplant Unit, Department of General Surgery, Digestive Tract and Abdominal Organ Transplantation, Hospital Universitario 12 de Octubre, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aguado</LastName><ForeName>Beatriz</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Transplant Unit. Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hernández</LastName><ForeName>Domingo</ForeName><Initials>D</Initials><Identifier Source="ORCID">0000-0001-5469-2119</Identifier><AffiliationInfo><Affiliation>Department of Nephrology, Hospital Regional Universitario, Málaga, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Spanish Society of Transplantation (SET), Málaga, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Domínguez-Gil</LastName><ForeName>Beatriz</ForeName><Initials>B</Initials><Identifier Source="ORCID">0000-0002-5695-8993</Identifier><AffiliationInfo><Affiliation>Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Spanish Group for the Study of COVID-19 in Transplant Recipients</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Transplant</MedlineTA><NlmUniqueID>100968638</NlmUniqueID><ISSNLinking>1600-6135</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018380" MajorTopicYN="Y">Hematopoietic Stem Cell Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016377" MajorTopicYN="Y">Organ Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D066027" MajorTopicYN="Y">Transplant Recipients</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">antibiotic: antiviral</Keyword><Keyword MajorTopicYN="Y">clinical decision-making</Keyword><Keyword MajorTopicYN="Y">clinical research/practice</Keyword><Keyword MajorTopicYN="Y">complication: infectious</Keyword><Keyword MajorTopicYN="Y">infection and infectious agents - viral</Keyword><Keyword MajorTopicYN="Y">infectious disease</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>10</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>10</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>24</Day><Hour>5</Hour><Minute>37</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33098200</ArticleId><ArticleId IdType="doi">10.1111/ajt.16369</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>Huang C, Wang Y, Li X, et al. 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