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COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Nov; Vol. 20 (11), pp. 3140-3148. Date of Electronic Publication: 2020 Aug 04. - Publication Year :
- 2020
-
Abstract
- Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVID-19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% were African American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), and heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%), and antivirals (14%). During a median follow-up period of 52 days (IQR: 16-66 days), acute kidney injury occurred in 52% cases, with respiratory failure requiring intubation in 29%, and the mortality rate was 32%. The 46 patients who died were older, had lower lymphocyte counts and estimated glomerular filtration rate levels, and had higher serum lactate dehydrogenase, procalcitonin, and interleukin-6 levels. In sum, hospitalized kidney transplant recipients with COVID-19 have higher rates of acute kidney injury and mortality.<br /> (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Aged
Comorbidity
Europe epidemiology
Female
Follow-Up Studies
Graft Rejection epidemiology
Humans
Immunocompromised Host
Immunosuppressive Agents therapeutic use
Male
Middle Aged
North America epidemiology
Retrospective Studies
COVID-19 epidemiology
Graft Rejection prevention & control
Immunosuppression Therapy methods
Kidney Transplantation statistics & numerical data
Pandemics
SARS-CoV-2
Transplant Recipients
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 20
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 32649791
- Full Text :
- https://doi.org/10.1111/ajt.16185