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  1. Article: Immunosuppression minimization in kidney transplant recipients hospitalized for COVID-19.

    Anton Pampols, Paula / Trujillo, Hernando / Melilli, Edoardo / Urban, Blanca / Sandino, Justo / Favá, Alexandre / Gutierrez, Eduardo / Bestard, Oriol / Mancebo, Esther / Sevillano, Angel / Cruzado, Josep M / Morales, Enrique

    Clinical kidney journal

    2021  Volume 14, Issue 4, Page(s) 1229–1235

    Abstract: Background: Immunosuppressed patients such as kidney transplant recipients (KTs) have increased ... that immunosuppression in KTs hospitalized due to COVID-19 could be safely minimized. ... of a cohort of 47 KTs admitted at two Spanish Kidney Transplant Units, who survived COVID-19. The impact ...

    Abstract Background: Immunosuppressed patients such as kidney transplant recipients (KTs) have increased mortality risk in the setting of coronavirus disease 2019 (COVID-19). The role and management of chronic immunosuppressive therapies during COVID-19 must be characterized.
    Methods: Herein, we report the follow-up of a cohort of 47 KTs admitted at two Spanish Kidney Transplant Units, who survived COVID-19. The impact of the management of immunosuppression during COVID-19 on graft function and immunologic events was evaluated.
    Results: At least one immunosuppressive agent was withdrawn in 83% of patients, with antimetabolites being the most frequent. Steroids were generally not stopped and the dose was even increased in 15% of patients as part of the treatment of COVID-19. Although immunosuppressive drugs were suspended during a median time of 17 days, no rejection episodes or
    Conclusions: Our observational study suggests that immunosuppression in KTs hospitalized due to COVID-19 could be safely minimized.
    Language English
    Publishing date 2021-01-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2655800-2
    ISSN 2048-8513 ; 2048-8505
    ISSN (online) 2048-8513
    ISSN 2048-8505
    DOI 10.1093/ckj/sfab025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Immunosuppression regimen modification during COVID-19 infection in kidney transplant recipients.

    Moein, Mahmoudreza / Martin, Samuel J / Whittemore, Carter / Thankachan, Reeba / Dvorai, Reut Hod / Saidi, Reza F

    Transplant immunology

    2023  Volume 80, Page(s) 101883

    Abstract: ... the immunosuppressive regimen continued as before during the COVID-19 infection. The mean time from the transplant ... the past 3 years. In this study, we focused on kidney transplant patients' course from the COVID-19 ... the COVID-19 infection affected the kidney and patients' quality of life during the hospitalization and ...

    Abstract Background: COVID-19 pandemic had tremendously affected all the aspects of human life during the past 3 years. In this study, we focused on kidney transplant patients' course from the COVID-19 diagnosis, immunosuppressive medication modification, hospitalization, and COVID-19 complications and how the COVID-19 infection affected the kidney and patients' quality of life during the hospitalization and after the discharge.
    Material and method: A retrospective analysis of a prospectively collected database of all kidney transplants adult patients who had a positive COVID-19 PCR from 1 January 2020 to 30 December 2022, and had a history of kidney transplant at the SUNY Upstate Medical Hospital was done to identify the cases.
    Results: 188 patients met the inclusion criteria and were included in the study. Based on the immunosuppressive regimen modification during COVID-19 infection, patients divided into two groups; in 143 (76%) patients, the immunosuppressive medication was reduced, and in 45 (24%) of patients, the immunosuppressive regimen continued as before during the COVID-19 infection. The mean time from the transplant to the diagnosis of COVID-19 was 67 months in the group we reduced the IM regimen, and 77 months in the group without changes in IM regimen. The mean recipients' age was 50.7 ± 12.9 years in the group we reduced the IM regimen, and 51.8 ± 16.4 years in the group without changes in IM regimen (P = 0.64). The vaccination rate against COVID-19 with at least 2 doses of either the CDC recommended Moderna or Pfizer vaccines was 80.2% in the group we reduced the IM regimen, and 84.8% in the group without changes in IM regimen (P = 0.55). The hospitalization rate due to COVID-19 related symptoms was 22.4% % in the group we reduced the IM regimen, and 35.5% in the group without changes in IM regimen (P = 0.12). However, the ICU admission rate was higher in the group we reduced the IM regimen, but the difference was not significant (26.5% Vs.6.25%, P = 0.12). 6 episodes of biopsy-proven rejection in the group with IM reduction was observed, which were 3 episodes of acute antibody-mediated rejections (ABMR) and 3 episodes of acute T-Cell-mediated rejections (TCMR), and 3 episodes in the group without any change in IM regimen, which were 2 episodes of ABMR and 1 episode of TCMR (P = 0.51). No significant difference was mentioned in the eGFR and serum creatinine after the comparison between the groups after 12 months of follow up. 124 patients responded to the post-COVID-19 questionnaires and were included in the data analysis. The response rate was 66%. Fatigue and exertion were the most reported symptom with a 43.9% prevalence.
    Conclusions: We found that immunosuppressive regimen minimization did not impact the kidney function in the long-term and it might be a helpful strategy to minimize the effect of COVID-19 infection on patients' condition during the hospital stay. With all the treatments, vaccinations, and precautions, still some patients did not achieve the complete recovery compared to their pre-COVID-19 health status. Fatigue was the main reported symptom amongst all the reported symptoms.
    Language English
    Publishing date 2023-07-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1160846-8
    ISSN 1878-5492 ; 0966-3274
    ISSN (online) 1878-5492
    ISSN 0966-3274
    DOI 10.1016/j.trim.2023.101883
    Database MEDical Literature Analysis and Retrieval System OnLINE

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