COVID-19 in solid organ transplant recipients: A single-center case series from Spain.
Identifieur interne : 001960 ( Main/Corpus ); précédent : 001959; suivant : 001961COVID-19 in solid organ transplant recipients: A single-center case series from Spain.
Auteurs : Mario Fernández-Ruiz ; Amado Andrés ; Carmelo Loinaz ; Juan F. Delgado ; Francisco L Pez-Medrano ; Rafael San Juan ; Esther González ; Natalia Polanco ; María D. Folgueira ; Antonio Lalueza ; Carlos Lumbreras ; José M. AguadoSource :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [ 1600-6143 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Antiviral Agents (administration & dosage), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (complications), Coronavirus Infections (mortality), Coronavirus Infections (therapy), Drug Combinations (MeSH), Female (MeSH), Fever (MeSH), Humans (MeSH), Hydroxychloroquine (administration & dosage), Immunosuppressive Agents (administration & dosage), Immunosuppressive Agents (adverse effects), Interferon-beta (administration & dosage), Lopinavir (administration & dosage), Male (MeSH), Middle Aged (MeSH), Organ Transplantation (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (mortality), Pneumonia, Viral (therapy), Radiography, Thoracic (MeSH), Retrospective Studies (MeSH), Ritonavir (administration & dosage), SARS-CoV-2 (MeSH), Spain (epidemiology), Transplant Recipients (MeSH).
- MESH :
- chemical , administration & dosage : Antiviral Agents, Hydroxychloroquine, Immunosuppressive Agents, Interferon-beta, Lopinavir, Ritonavir.
- chemical , adverse effects : Immunosuppressive Agents.
- geographic , epidemiology : Spain.
- complications : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Aged, Betacoronavirus, COVID-19, Drug Combinations, Female, Fever, Humans, Male, Middle Aged, Organ Transplantation, Pandemics, Radiography, Thoracic, Retrospective Studies, SARS-CoV-2, Transplant Recipients.
Abstract
The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon-β (16.7%). As of April 4, the case-fatality rate was 27.8% (5/18). After a median follow-up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C-reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS-CoV-2 infection has a severe course in SOT recipients.
DOI: 10.1111/ajt.15929
PubMed: 32301155
Links to Exploration step
pubmed:32301155Le document en format XML
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<author><name sortKey="Folgueira, Maria D" sort="Folgueira, Maria D" uniqKey="Folgueira M" first="María D" last="Folgueira">María D. Folgueira</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 in solid organ transplant recipients: A single-center case series from Spain.</title>
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<author><name sortKey="Loinaz, Carmelo" sort="Loinaz, Carmelo" uniqKey="Loinaz C" first="Carmelo" last="Loinaz">Carmelo Loinaz</name>
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<author><name sortKey="Delgado, Juan F" sort="Delgado, Juan F" uniqKey="Delgado J" first="Juan F" last="Delgado">Juan F. Delgado</name>
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</affiliation>
<affiliation><nlm:affiliation>CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.</nlm:affiliation>
</affiliation>
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<author><name sortKey="L Pez Medrano, Francisco" sort="L Pez Medrano, Francisco" uniqKey="L Pez Medrano F" first="Francisco" last="L Pez-Medrano">Francisco L Pez-Medrano</name>
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<author><name sortKey="San Juan, Rafael" sort="San Juan, Rafael" uniqKey="San Juan R" first="Rafael" last="San Juan">Rafael San Juan</name>
<affiliation><nlm:affiliation>Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</nlm:affiliation>
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<author><name sortKey="Gonzalez, Esther" sort="Gonzalez, Esther" uniqKey="Gonzalez E" first="Esther" last="González">Esther González</name>
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<author><name sortKey="Polanco, Natalia" sort="Polanco, Natalia" uniqKey="Polanco N" first="Natalia" last="Polanco">Natalia Polanco</name>
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<author><name sortKey="Folgueira, Maria D" sort="Folgueira, Maria D" uniqKey="Folgueira M" first="María D" last="Folgueira">María D. Folgueira</name>
<affiliation><nlm:affiliation>Department of Microbiology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lalueza, Antonio" sort="Lalueza, Antonio" uniqKey="Lalueza A" first="Antonio" last="Lalueza">Antonio Lalueza</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lumbreras, Carlos" sort="Lumbreras, Carlos" uniqKey="Lumbreras C" first="Carlos" last="Lumbreras">Carlos Lumbreras</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Aguado, Jose M" sort="Aguado, Jose M" uniqKey="Aguado J" first="José M" last="Aguado">José M. Aguado</name>
<affiliation><nlm:affiliation>Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</nlm:affiliation>
</affiliation>
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<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="2020" type="published">2020</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Antiviral Agents (administration & dosage)</term>
<term>Betacoronavirus (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>Coronavirus Infections (complications)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (therapy)</term>
<term>Drug Combinations (MeSH)</term>
<term>Female (MeSH)</term>
<term>Fever (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (administration & dosage)</term>
<term>Immunosuppressive Agents (administration & dosage)</term>
<term>Immunosuppressive Agents (adverse effects)</term>
<term>Interferon-beta (administration & dosage)</term>
<term>Lopinavir (administration & dosage)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Organ Transplantation (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (complications)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (therapy)</term>
<term>Radiography, Thoracic (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Ritonavir (administration & dosage)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Spain (epidemiology)</term>
<term>Transplant Recipients (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiviral Agents</term>
<term>Hydroxychloroquine</term>
<term>Immunosuppressive Agents</term>
<term>Interferon-beta</term>
<term>Lopinavir</term>
<term>Ritonavir</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Immunosuppressive Agents</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<term>COVID-19</term>
<term>Drug Combinations</term>
<term>Female</term>
<term>Fever</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Organ Transplantation</term>
<term>Pandemics</term>
<term>Radiography, Thoracic</term>
<term>Retrospective Studies</term>
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<front><div type="abstract" xml:lang="en">The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon-β (16.7%). As of April 4, the case-fatality rate was 27.8% (5/18). After a median follow-up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C-reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS-CoV-2 infection has a severe course in SOT recipients.</div>
</front>
</TEI>
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<DateCompleted><Year>2020</Year>
<Month>07</Month>
<Day>20</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>12</Month>
<Day>18</Day>
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<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1600-6143</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>20</Volume>
<Issue>7</Issue>
<PubDate><Year>2020</Year>
<Month>07</Month>
</PubDate>
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<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 solid organ transplant recipients: A single-center case series from Spain.</ArticleTitle>
<Pagination><MedlinePgn>1849-1858</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1111/ajt.15929</ELocationID>
<Abstract><AbstractText>The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon-β (16.7%). As of April 4, the case-fatality rate was 27.8% (5/18). After a median follow-up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C-reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS-CoV-2 infection has a severe course in SOT recipients.</AbstractText>
<CopyrightInformation>© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><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 "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Andrés</LastName>
<ForeName>Amado</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0003-0238-1364</Identifier>
<AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Loinaz</LastName>
<ForeName>Carmelo</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of General Surgery, Digestive Tract and Abdominal Organ Transplantation, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Delgado</LastName>
<ForeName>Juan F</ForeName>
<Initials>JF</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>López-Medrano</LastName>
<ForeName>Francisco</ForeName>
<Initials>F</Initials>
<Identifier Source="ORCID">0000-0001-5333-7529</Identifier>
<AffiliationInfo><Affiliation>Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>San Juan</LastName>
<ForeName>Rafael</ForeName>
<Initials>R</Initials>
<Identifier Source="ORCID">0000-0003-3446-1991</Identifier>
<AffiliationInfo><Affiliation>Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>González</LastName>
<ForeName>Esther</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Polanco</LastName>
<ForeName>Natalia</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Folgueira</LastName>
<ForeName>María D</ForeName>
<Initials>MD</Initials>
<AffiliationInfo><Affiliation>Department of Microbiology, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lalueza</LastName>
<ForeName>Antonio</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lumbreras</LastName>
<ForeName>Carlos</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Aguado</LastName>
<ForeName>José M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><Agency>Spanish Ministry of Science and Innovation</Agency>
<Country>International</Country>
</Grant>
<Grant><GrantID>13/00045</GrantID>
<Agency>Instituto de Salud Carlos III</Agency>
<Country>International</Country>
</Grant>
<Grant><GrantID>CP 18/00073</GrantID>
<Agency>Instituto de Salud Carlos III</Agency>
<Country>International</Country>
</Grant>
<Grant><GrantID>COV 20/00181</GrantID>
<Agency>Instituto de Salud Carlos III</Agency>
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