SrasV1, 2020, Analysis, bibRecord, 000A21

A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia.

Identifieur interne : 000A21 ( 2020/Analysis ); précédent : 000A20; suivant : 000A22

A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia.

Auteurs : Federico Alberici [Italie] ; Elisa Delbarba [Italie] ; Chiara Manenti [Italie] ; Laura Econimo [Italie] ; Francesca Valerio [Italie] ; Alessandra Pola [Italie] ; Camilla Maffei [Italie] ; Stefano Possenti [Italie] ; Nicole Zambetti [Italie] ; Marianna Moscato [Italie] ; Margherita Venturini [Italie] ; Stefania Affatato [Italie] ; Mario Gaggiotti [Italie] ; Nicola Bossini [Italie] ; Francesco Scolari [Italie]

Source :

Kidney International [ 0085-2538 ] ; 2020.

RBID : PMC:7142691

Abstract

The outcome of SARS-CoV2 infection in patients who have received a kidney allograft and are being treated with immunosuppression is unclear. We describe 20 kidney transplant recipients (median age 59 years [inter quartile range 51-64 years], median age of transplant 13 years [9-20 years], baseline eGFR 36.5 [23-47.5]) with SARS-CoV2 induced pneumonia. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/day, all but one was commenced on antiviral therapy and hydroxychloroquine with doses adjusted for kidney function. At baseline, all patients presented fever but only one complained of difficulty in breathing. Half of patients showed chest radiographic evidence of bilateral infiltrates while the other half showed unilateral changes or no infiltrates. During a median follow-up of seven days, 87% experienced a radiological progression and among those 73% required escalation of oxygen therapy. Six patients developed acute kidney injury with one requiring hemodialysis. Six of 12 patients were treated with tocilizumab, a humanized monoclonal antibody to the IL-6 receptor. Overall, five kidney transplant recipients died after a median period of 15 days [15-19] from symptom onset. These preliminary findings describe a rapid clinical deterioration associated with chest radiographic deterioration and escalating oxygen requirement in renal transplant recipients with SARS-Cov2 pneumonia. Thus, in this limited cohort of long-term kidney transplant patients, SARS-CoV-2 induced pneumonia is characterized by high risk of progression and significant mortality.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142691

DOI: 10.1016/j.kint.2020.04.002
PubMed: NONE
PubMed Central: 7142691

Affiliations:

Italie

Links to Exploration step

PMC:7142691

Le document en format XML

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<author><name sortKey="Zambetti, Nicole" sort="Zambetti, Nicole" uniqKey="Zambetti N" first="Nicole" last="Zambetti">Nicole Zambetti</name>
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<author><name sortKey="Venturini, Margherita" sort="Venturini, Margherita" uniqKey="Venturini M" first="Margherita" last="Venturini">Margherita Venturini</name>
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<author><name sortKey="Affatato, Stefania" sort="Affatato, Stefania" uniqKey="Affatato S" first="Stefania" last="Affatato">Stefania Affatato</name>
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<series><title level="j">Kidney International</title>
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<front><div type="abstract" xml:lang="en"><p>The outcome of SARS-CoV2 infection in patients who have received a kidney allograft and are being treated with immunosuppression is unclear. We describe 20 kidney transplant recipients (median age 59 years [inter quartile range 51-64 years], median age of transplant 13 years [9-20 years], baseline eGFR 36.5 [23-47.5]) with SARS-CoV2 induced pneumonia. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/day, all but one was commenced on antiviral therapy and hydroxychloroquine with doses adjusted for kidney function. At baseline, all patients presented fever but only one complained of difficulty in breathing. Half of patients showed chest radiographic evidence of bilateral infiltrates while the other half showed unilateral changes or no infiltrates. During a median follow-up of seven days, 87% experienced a radiological progression and among those 73% required escalation of oxygen therapy. Six patients developed acute kidney injury with one requiring hemodialysis. Six of 12 patients were treated with tocilizumab, a humanized monoclonal antibody to the IL-6 receptor. Overall, five kidney transplant recipients died after a median period of 15 days [15-19] from symptom onset. These preliminary findings describe a rapid clinical deterioration associated with chest radiographic deterioration and escalating oxygen requirement in renal transplant recipients with SARS-Cov2 pneumonia. Thus, in this limited cohort of long-term kidney transplant patients, SARS-CoV-2 induced pneumonia is characterized by high risk of progression and significant mortality.</p>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cao, B" uniqKey="Cao B">B. Cao</name>
</author>
<author><name sortKey="Wang, Y" uniqKey="Wang Y">Y. Wang</name>
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<author><name sortKey="Wang, J" uniqKey="Wang J">J. Wang</name>
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<author><name sortKey="Fan, G" uniqKey="Fan G">G. Fan</name>
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<author><name sortKey="Wang, Y" uniqKey="Wang Y">Y. Wang</name>
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<author><name sortKey="Ren, L" uniqKey="Ren L">L. Ren</name>
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<author><name sortKey="Zhao, J" uniqKey="Zhao J">J. Zhao</name>
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<author><name sortKey="Parola, P" uniqKey="Parola P">P. Parola</name>
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<author><name sortKey="Hoang, V T" uniqKey="Hoang V">V.T. Hoang</name>
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<author><name sortKey="Meddeb, L" uniqKey="Meddeb L">L. Meddeb</name>
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<author><name sortKey="Chen, X" uniqKey="Chen X">X. Chen</name>
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<author><name sortKey="Cai, Y" uniqKey="Cai Y">Y. Cai</name>
</author>
<author><name sortKey="Xia, J" uniqKey="Xia J">J. Xia</name>
</author>
<author><name sortKey="Zhou, X" uniqKey="Zhou X">X. Zhou</name>
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<author><name sortKey="Xu, S" uniqKey="Xu S">S. Xu</name>
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</record>

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   |wiki=    Sante
   |area=    SrasV1
   |flux=    2020
   |étape=   Analysis
   |type=    RBID
   |clé=     PMC:7142691
   |texte=   A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia.
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A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia.

A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia.

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Abstract

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