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Article ; Online: Solid organ transplantation is not a risk factor for COVID-19 disease outcome.

Hugo, Christian / Stecher, Melanie / Dolff, Sebastian / Nattermann, Jacob / Vehreschild, Jörg / Hippchen, Theresa / Westhoff, Timm / Bertolo, Martina / Hohenstein, Bernd / Hanses, Frank / Strassburg, Christian

Transplant international : official journal of the European Society for Organ Transplantation

2021 Volume 34, Issue 2, Page(s) 378–381

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/etiology ; COVID-19/mortality ; COVID-19/therapy ; Case-Control Studies ; Female ; Germany/epidemiology ; Humans ; Logistic Models ; Male ; Matched-Pair Analysis ; Middle Aged ; Organ Transplantation ; Postoperative Complications/diagnosis ; Postoperative Complications/mortality ; Postoperative Complications/therapy ; Prognosis ; Risk Factors
Language	English
Publishing date	2021-01-10
Publishing country	England
Document type	Letter
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13795
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Zs.A 2358: Show issues

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Article ; Online: COVID-19 Disease in Pediatric Solid Organ Transplantation from Alpha to Omicron: A High Monocyte Count in the Preceding Three Months Portends a Risk for Severe Disease.

Sirgi, Yasmina / Stanojevic, Maja / Ahn, Jaeil / Yazigi, Nada / Kaufman, Stuart / Khan, Khalid / Vitola, Bernadette / Matsumoto, Cal / Kroemer, Alexander / Fishbein, Thomas / Ekong, Udeme D

Viruses

2023 Volume 15, Issue 7

Abstract: ... lymphocyte count at diagnosis decreased the odds of having severe COVID-19 disease (OR 0.29; CI 0.11-0.60 ... who care for immunocompromised patients.: Objective: to determine factors associated with COVID-19 ... potentially confirms the importance of monocytic inflammasome-driven inflammation in COVID-19 pathogenesis ...

Abstract	Importance: Planning for future resurgences in SARS-CoV-2 infection is necessary for providers who care for immunocompromised patients. Objective: to determine factors associated with COVID-19 disease severity in immunosuppressed children. Design: a case series of children with solid organ transplants diagnosed with SARS-CoV-2 infection between 15 March 2020 and 31 March 2023. Setting: a single pediatric transplant center. Participants: all children with a composite transplant (liver, pancreas, intestine), isolated intestine transplant (IT), isolated liver transplant LT), or simultaneous liver kidney transplant (SLK) with a positive PCR for SARS-CoV-2. Exposure: SARS-CoV-2 infection. Main outcome and measures: We hypothesized that children on the most immunosuppression, defined by the number of immunosuppressive medications and usage of steroids, would have the most severe disease course and that differential white blood cell count in the months preceding infection would be associated with likelihood of having severe disease. The hypothesis being tested was formulated during data collection. The primary study outcome measurement was disease severity defined using WHO criteria. Results: 77 children (50 LT, 24 intestine, 3 SLK) were infected with SARS-CoV-2, 57.4 months from transplant (IQR 19.7-87.2). 17% were ≤1 year post transplant at infection. 55% were male, 58% were symptomatic and ~29% had severe disease. A high absolute lymphocyte count at diagnosis decreased the odds of having severe COVID-19 disease (OR 0.29; CI 0.11-0.60; Conclusions and relevance: The significance of a high monocyte count as predictor of severe disease potentially confirms the importance of monocytic inflammasome-driven inflammation in COVID-19 pathogenesis. Our data do not support reducing immunosuppression in the setting of infection. Our observations may have important ramifications in resource management as vaccine- and infection-induced immunity wanes.
MeSH term(s)	Humans ; Child ; Organ Transplantation ; COVID-19/diagnosis ; COVID-19/epidemiology ; Patient Acuity ; Male ; Female ; Child, Preschool ; Immunosuppressive Agents/therapeutic use ; Steroids/therapeutic use ; Lymphocyte Count ; Monocytes/cytology ; Graft Rejection
Chemical Substances	Immunosuppressive Agents ; Steroids
Language	English
Publishing date	2023-07-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v15071559
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Book ; Online: COVID-19 in Patients with Solid Organ Transplantation

René Hage / Carolin Steinack / Christian Benden / Macé M. Schuurmans

Transplantology ; Volume 1 ; Issue 1 ; Pages 1-15

A Systematic Review

2020

Abstract: ... for other factors potentially impacting COVID-19 severity and outcome. ... SARS-CoV-2 infection and COVID-19 outcomes. The focus was the severity of the disease, the need ... organ transplant (SOT) recipients are immunosuppressed, and therefore are generally considered at an increased risk ...

Abstract	The novel coronavirus, SARS-CoV-2, is causing a pandemic of unknown precedent, with huge healthcare challenges and worldwide disruptions to economic and social life. Lung transplant recipients and other solid organ transplant (SOT) recipients are immunosuppressed, and therefore are generally considered at an increased risk for severe infections. Given the current gap in knowledge and evidence regarding the best management of these patients, we conducted a systematic review of studies on SARS-CoV-2 infections and Coronavirus Disease 2019 (COVID-19) in SOT recipients, to evaluate the association between immunosuppression in these patients, SARS-CoV-2 infection and COVID-19 outcomes. The focus was the severity of the disease, the need for mechanical ventilation and intensive care unit (ICU) admissions, and rate of death. The literature search was conducted repeatedly between 16 March and 8 April 2020. We searched original papers, observational studies, case reports, and meta-analyses published between 2019 and 2020 using two databases (PubMed, Google Scholar) with the search terms: [transplant OR immunosuppression] AND [COVID-19 OR SARS-CoV-2]. Further inclusion criteria were publications in English, French, German and Italian, and reference to humans. We also searched the reference lists of the studies encountered. From an initial search of PubMed and Google Scholar, 19 potential articles were retrieved, of which 14 were excluded after full-text screening (not being case reports or case series), leaving 5 studies for inclusion. No further studies were identified from the bibliographies of retrieved articles. Based on the limited research, no firm conclusions can be made concerning SOT recipients, but the current evidence suggests that immunosuppression is most likely associated with a better outcome of SARS-CoV-2 infection and COVID-19 because it prevents hyperinflammation (cytokine storm) in this particular population. There is a need for further research that would allow results to be adjusted for other factors potentially impacting COVID-19 severity and outcome.
Keywords	SARS-CoV-2 ; coronavirus ; immunosuppression ; tacrolimus ; corticosteroids ; mycophenolate mofetil ; hyperinflammation ; cytokine storm ; pandemic ; transplantation ; covid19
Subject code	610
Language	English
Publishing date	2020-05-07
Publisher	Multidisciplinary Digital Publishing Institute
Publishing country	ch
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience.

Darılmaz Yüce, Gülbahar / Ulubay, Gaye / Tek, Korhan / Savaş Bozbaş, Şerife / Erol, Çiğdem / Büyükaşık, Pırıl / Haberal, Kemal Murat / Arslan, Ayşe Hande / Akçay, Müşerref Şule / Haberal, Mehmet

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

2021 Volume 21, Issue 5, Page(s) 451–459

Abstract: ... of COVID-19 in solid-organ transplant recipients have not been well defined. This study ... investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey ... COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown ...

Abstract	Objectives: The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. Materials and methods: Our study included 23 solidorgan transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant. Results: Mean age of solid-organ transplant recipients was 49.8 ± 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P = .224). Transplant recipients had greater requirements for nasal oxygen (P = .005) and noninvasive mechanical ventilation (P = .003) and had longer length of intensive care unit stay (P = .030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P = .439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients. Conclusions: COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.
MeSH term(s)	Male ; Humans ; Female ; Adult ; Middle Aged ; COVID-19/diagnosis ; Coinfection ; Universities ; SARS-CoV-2 ; Risk Factors ; Organ Transplantation/adverse effects ; Transplant Recipients ; Retrospective Studies
Language	English
Publishing date	2021-10-11
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2396778-X
ISSN	2146-8427 ; 1304-0855
ISSN (online)	2146-8427
ISSN	1304-0855
DOI	10.6002/ect.2021.0361
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Article ; Online: Difference between SARS-CoV-2, seasonal coronavirus, influenza, and respiratory syncytial virus infection in solid organ transplant recipients.

Mendoza, Maria A / Motoa, Gabriel / Raja, Mohammed A / Frattaroli, Paola / Fernandez, Anmary / Anjan, Shweta / Courel, Steve C / Natori, Akina / O'Brien, Cristopher B / Phancao, Anita / Sinha, Neeraj / Vianna, Rodrigo / Loebe, Mathias / Ciancio, Gaetano / Simkins, Jacques / Abbo, Lilian / Guerra, Giselle / Natori, Yoichiro

Transplant infectious disease : an official journal of the Transplantation Society

2022 Volume 25, Issue 1, Page(s) e13998

Abstract: ... since the end of 2019 and has shown worse outcomes in solid organ transplant (SOT) recipients. The clinical ... mortality among SARS-CoV-2 infected recipients. Older age was found to be the risk factor for lower ... differences as well as outcomes between respiratory viruses have not been well defined in this population ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been raging since the end of 2019 and has shown worse outcomes in solid organ transplant (SOT) recipients. The clinical differences as well as outcomes between respiratory viruses have not been well defined in this population. Methods: This is a retrospective cohort study of adult SOT recipients with nasopharyngeal swab or bronchoalveolar lavage PCR positive for either SARS-CoV-2, seasonal coronavirus, respiratory syncytial virus (RSV) or influenza virus from January 2017 to October 2020. The follow up period was 3 months. Clinical characteristics and outcomes were evaluated. Results: A total of 377 recipients including 157 SARS-CoV-2, 70 seasonal coronavirus, 50 RSV and 100 influenza infections were identified. The most common transplanted organ was kidney 224/377 (59.4%). Lower respiratory tract infection (LRTI) was found in 210/377 (55.7%) and the risk factors identified with multivariable analysis were SARS-CoV-2 infection, steroid use, and older age. Co- and secondary infections were seen in 77/377 (20.4%) recipients with bacterial pathogens as dominant. Hospital admission was seen in 266/377 (67.7%) recipients without significant statistical difference among viruses, however, ICU admission, mechanical ventilation and mortality were higher with SARS-CoV-2 infection. In the multivariable model, the risk factors for mortality were SARS-CoV-2 infection and older age. Conclusions: We found higher incidence of ICU admission, mechanical ventilation, and mortality among SARS-CoV-2 infected recipients. Older age was found to be the risk factor for lower respiratory tract infection and mortality for SARS-CoV-2, coronaviruses, RSV and influenza virus groups.
MeSH term(s)	Adult ; Humans ; Respiratory Syncytial Virus Infections ; SARS-CoV-2 ; Influenza, Human/etiology ; COVID-19 ; Retrospective Studies ; Seasons ; Organ Transplantation/adverse effects ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; Transplant Recipients
Language	English
Publishing date	2022-12-14
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13998
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Zs.A 5100: Show issues

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Article ; Online: Humoral immune response following a third SARS-CoV-2 mRNA vaccine dose in solid organ transplant recipients compared with matched controls.

Balsby, Daniel / Nilsson, Anna Christine / Petersen, Inge / Lindvig, Susan O / Davidsen, Jesper Rømhild / Abazi, Rozeta / Poulsen, Mikael K / Holden, Inge K / Justesen, Ulrik S / Bistrup, Claus / Johansen, Isik Somuncu

Frontiers in immunology

2022 Volume 13, Page(s) 1039245

Abstract: ... following COVID-19 vaccination. Several risk factors for the diminished response have been identified ... Background: Solid organ transplant (SOT) recipients have shown suboptimal antibody response ... including immunosuppression and older age, but the influence of different comorbidities is not fully ...

Abstract	Background: Solid organ transplant (SOT) recipients have shown suboptimal antibody response following COVID-19 vaccination. Several risk factors for the diminished response have been identified including immunosuppression and older age, but the influence of different comorbidities is not fully elucidated. Method: This case-control study consisted of 420 Danish adult SOT recipients and 840 sex- and age-matched controls, all vaccinated with a third homologous dose of either BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine. The primary outcome was differences in humoral immune response. The secondary outcome was breakthrough infections. Additionally, we looked for factors that could predict possible differences between the two groups. Results: Response rate increased from 186/382 (49%) to 275/358 (77%) in SOT recipients and remained on 781/790 (99%) to 601/609 (99%) in controls following a third vaccine dose. SOT recipients had significantly lower median antibody concentrations after third dose compared to controls (332.6 BAU/ml vs 46,470.0 BAU/ml, p <0.001). Lowest median antibody concentrations were seen in SOT recipients with liver disease (10.3 BAU/ml, IQR 7.1-319) and diabetes (275.3 BAU/ml, IQR 7.3-957.4). Breakthrough infections occurred similarly frequent, 150 (40%) among cases and 301 (39%) among controls (p = 0.80). Conclusion: A third COVID-19 vaccine dose resulted in a significant increase in humoral immunogenicity in SOT recipients and maintained high response rate in controls. Furthermore, SOT recipients were less likely to produce antibodies with overall lower antibody concentrations and humoral immunity was highly influenced by the presence of liver disease and diabetes. The prevalence of breakthrough infections was similar in the two groups.
MeSH term(s)	Adult ; Humans ; Immunity, Humoral ; COVID-19 Vaccines ; SARS-CoV-2 ; BNT162 Vaccine ; Case-Control Studies ; COVID-19/prevention & control ; Antibodies ; Breakthrough Infections ; Organ Transplantation/adverse effects ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; BNT162 Vaccine ; Antibodies
Language	English
Publishing date	2022-12-09
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.1039245
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Article: COVID-19 in Patients with Solid Organ Transplantation: A Systematic Review

Hage, René / Steinack, Carolin / Benden, Christian / Schuurmans, Macé M.

Transplantology 2020, Vol. 1, Pages 1-15

Abstract: ... for other factors potentially impacting COVID-19 severity and outcome ... SARS-CoV-2 infection and COVID-19 outcomes The focus was the severity of the disease, the need ... organ transplant (SOT) recipients are immunosuppressed, and therefore are generally considered at an increased risk ...

Abstract	The novel coronavirus, SARS-CoV-2, is causing a pandemic of unknown precedent, with huge healthcare challenges and worldwide disruptions to economic and social life Lung transplant recipients and other solid organ transplant (SOT) recipients are immunosuppressed, and therefore are generally considered at an increased risk for severe infections Given the current gap in knowledge and evidence regarding the best management of these patients, we conducted a systematic review of studies on SARS-CoV-2 infections and Coronavirus Disease 2019 (COVID-19) in SOT recipients, to evaluate the association between immunosuppression in these patients, SARS-CoV-2 infection and COVID-19 outcomes The focus was the severity of the disease, the need for mechanical ventilation and intensive care unit (ICU) admissions, and rate of death The literature search was conducted repeatedly between 16 March and 8 April 2020 We searched original papers, observational studies, case reports, and meta-analyses published between 2019 and 2020 using two databases (PubMed, Google Scholar) with the search terms: [transplant OR immunosuppression] AND [COVID-19 OR SARS-CoV-2] Further inclusion criteria were publications in English, French, German and Italian, and reference to humans We also searched the reference lists of the studies encountered From an initial search of PubMed and Google Scholar, 19 potential articles were retrieved, of which 14 were excluded after full-text screening (not being case reports or case series), leaving 5 studies for inclusion No further studies were identified from the bibliographies of retrieved articles Based on the limited research, no firm conclusions can be made concerning SOT recipients, but the current evidence suggests that immunosuppression is most likely associated with a better outcome of SARS-CoV-2 infection and COVID-19 because it prevents hyperinflammation (cytokine storm) in this particular population There is a need for further research that would allow results to be adjusted for other factors potentially impacting COVID-19 severity and outcome
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #197615
Database	COVID19

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Article ; Online: Solid organ transplantation is not a risk factor for COVID-19 disease outcome.

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Article ; Online: COVID-19 Disease in Pediatric Solid Organ Transplantation from Alpha to Omicron: A High Monocyte Count in the Preceding Three Months Portends a Risk for Severe Disease.

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Book ; Online: COVID-19 in Patients with Solid Organ Transplantation

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Article ; Online: Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience.

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Article ; Online: Difference between SARS-CoV-2, seasonal coronavirus, influenza, and respiratory syncytial virus infection in solid organ transplant recipients.

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Article ; Online: Humoral immune response following a third SARS-CoV-2 mRNA vaccine dose in solid organ transplant recipients compared with matched controls.

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Article: COVID-19 in Patients with Solid Organ Transplantation: A Systematic Review

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