Article ; Online: Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study.
2021 Volume 53, Issue 4, Page(s) 1187–1193
Abstract: Background: Kidney transplant recipients (KTR) are considered high-risk for morbidity and ... mortality from coronavirus disease 2019 (COVID-19). However, some studies did not show worse outcomes ... hospitalized KTR and non-transplant patients, matched by age and sex (controls).: Results: Eleven KTR were ...
| Abstract | Background: Kidney transplant recipients (KTR) are considered high-risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). However, some studies did not show worse outcomes compared to non-transplant patients and there is little data about immunosuppressant drug levels and secondary infections in KTR with COVID-19. Herein, we describe our single-center experience with COVID-19 in KTR. Methods: We captured KTR diagnosed with COVID-19 between March 1, 2020 and May 18, 2020. After exclusion of KTR on hemodialysis and off immunosuppression, we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by age and sex (controls). Results: Eleven KTR were hospitalized and matched with 44 controls. One KTR and 4 controls died (case fatality rate: 9.1%). There were no significant differences in length of stay or clinical outcomes between KTR and controls. Tacrolimus or sirolimus levels were >10 ng/mL in 6 out of 9 KTR (67%). Bacterial infections were more frequent in KTR (36.3%), compared with controls (6.8%, P = .02). Conclusions: In our small case series, unlike earlier reports from the pandemic epicenters, the clinical outcomes of KTR with COVID-19 were comparable to those of non-transplant patients. Calcineurin or mammalian target of rapamycin inhibitor (mTOR) levels were high. Bacterial infections were more common in KTR, compared with controls. |
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| MeSH term(s) | Adult ; Aged ; Antiviral Agents/therapeutic use ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/virology ; Case-Control Studies ; Female ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Kidney Transplantation ; Length of Stay ; Male ; Middle Aged ; Pandemics ; SARS-CoV-2/isolation & purification ; Sirolimus/therapeutic use ; TOR Serine-Threonine Kinases/metabolism ; Tacrolimus/therapeutic use ; Treatment Outcome ; COVID-19 Drug Treatment | |||||
| Chemical Substances | Antiviral Agents ; Immunosuppressive Agents ; MTOR protein, human (EC 2.7.1.1) ; TOR Serine-Threonine Kinases (EC 2.7.11.1) ; Sirolimus (W36ZG6FT64) ; Tacrolimus (WM0HAQ4WNM) | |||||
| Language | English | |||||
| Publishing date | 2021-01-13 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 82046-5 | |||||
| ISSN | 1873-2623 ; 0041-1345 | |||||
| ISSN (online) | 1873-2623 | |||||
| ISSN | 0041-1345 | |||||
| DOI | 10.1016/j.transproceed.2021.01.002 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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