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Article: Kidney transplantation and COVID-19 renal and patient prognosis.

Toapanta, Néstor / Torres, Irina B / Sellarés, Joana / Chamoun, Betty / Serón, Daniel / Moreso, Francesc

2021 Volume 14, Issue Suppl 1, Page(s) i21–i29

Abstract: ... and calcineurin inhibitor reduction for transplant patients with COVID-19 are not based on high ... reported. The number of renal transplant patients diagnosed with COVID-19 was higher than in the general ... quickly and renal transplant recipients receiving chronic immunosuppression have been considered ...

Abstract	Coronavirus disease 2019 (COVD-19) emerged as a pandemic in December 2019. Infection has spread quickly and renal transplant recipients receiving chronic immunosuppression have been considered a population at high risk of infection, complications and infection-related death. During this year a large amount of information from nationwide registries, multicentre and single-centre studies have been reported. The number of renal transplant patients diagnosed with COVID-19 was higher than in the general population, but the lower threshold for testing may have contributed to its better identification. Major complications such as acute kidney injury and acute respiratory distress syndrome were very frequent in renal transplant patients, with a high comorbidity burden, but further studies are needed to support that organ transplant recipients receiving chronic immunosuppression are more prone to develop these complications than the general population. Kidney transplant recipients experience a high mortality rate compared with the general population, especially during the very early post-transplant period. Despite the fact that some studies report more favourable outcomes in patients with a kidney transplant than in patients on the kidney waiting list, the higher mortality described in the very early post-transplant period would advise against performing a kidney transplant in areas where the spread of infection is high, especially in recipients >60 years of age. Management of transplant recipients has been challenging for clinicians and strategies such as less use of lymphocyte-depleting agents for new transplants or anti-metabolite withdrawal and calcineurin inhibitor reduction for transplant patients with COVID-19 are not based on high-quality evidence.
Language	English
Publishing date	2021-03-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfab030
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Zs.A 6587: Show issues

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Article: Coronavirus Disease 2019 and the Kidney.

Jaryal, Ajay / Vikrant, Sanjay

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2022 Volume 32, Issue 5, Page(s) 1220–1234

Abstract: ... those on dialysis and kidney transplant recipients, are predisposed to the worst outcomes with COVID-19. It also ... in these patients. It also creates a huge demand for the delivery of renal replacement therapy. COVID-19 is ... of kidney diseases in COVID-19. ...

Abstract	Coronaviruses are ubiquitous pathogens and have caused epidemics in the recent past. Coupled with globalization, they have the potential to transform into the pandemic, as is the case of coronavirus disease 2019 (COVID-19). Primarily to start as a respiratory illness, they are known to cause systemic disease and affect many organ systems. Due to the lack of, universally proven, specific anti-viral therapy, the mainstay of treatment is "supportive care" and some of the patients afflicted with it, require intensive care and organ support for lungs and/or kidneys. Patients with the diseases of the kidney, particularly those on dialysis and kidney transplant recipients, are predisposed to the worst outcomes with COVID-19. It also leads to acute kidney injury, which is an important and independent determinant of prognosis in these patients. It also creates a huge demand for the delivery of renal replacement therapy. COVID-19 is an emerging and evolving disease, and so, it is important to understand the mechanism and management of kidney diseases in COVID-19.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; COVID-19 ; Female ; Humans ; Kidney ; Male ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2022-05-09
Publishing country	Saudi Arabia
Document type	Journal Article ; Review
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.344741
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Zs.A 4735: Show issues

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Article ; Online: COVID-19 and kidney transplantation.

Caillard, Sophie

Presse medicale (Paris, France : 1983)

2022 Volume 51, Issue 4, Page(s) 104146

Abstract: ... 19 was evaluated at 23% and renal failure plays a major role in the poor prognosis in addition ... risk factors and to define its prognosis. The 60 days-mortality of transplant patients hospitalized for COVID ... The COVID-19 pandemic affects the transplant recipients since March 2020. Transplant centers ...

Abstract	The COVID-19 pandemic affects the transplant recipients since March 2020. Transplant centers quickly organized themselves to optimize the management of the immunocompromised patients and to progress in the knowledge of this new disease. To this end, a French Registry was created, which includes all solid organ transplant patients who have developed a SARS Cov2 infection. Numerous studies have been carried out using these data to describe this new disease in transplant patients, to characterize its clinical and biological risk factors and to define its prognosis. The 60 days-mortality of transplant patients hospitalized for COVID-19 was evaluated at 23% and renal failure plays a major role in the poor prognosis in addition to the classical risk factors described in the general population. The advent of vaccination has been a great relief but transplanted patients have shown a poor vaccine response keeping them at risk of severe disease even after an adapted vaccination scheme. Specific strategies was proposed in this particularly fragile population like increasing vaccine doses or using anti SARS Cov-2 monoclonal antibodies.
Language	English
Publishing date	2022-11-05
Publishing country	France
Document type	Journal Article
ZDB-ID	120943-7
ISSN	2213-0276 ; 0032-7867 ; 0755-4982 ; 0301-1518
ISSN (online)	2213-0276
ISSN	0032-7867 ; 0755-4982 ; 0301-1518
DOI	10.1016/j.lpm.2022.104146
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Zs.A 794: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: COVID-19 and Kidney Disease: A Clinical Perspective.

Theofilis, Panagiotis / Vordoni, Aikaterini / Kalaitzidis, Rigas G

Current vascular pharmacology

2022 Volume 20, Issue 4, Page(s) 321–325

Abstract: ... 19 AKI, there is a gradual recovery of kidney function, with pre-existing renal impairment and high ... risk factor. Regarding COVID-19 complications, other than classical pneumonia and thromboembolism ... of controversy. Indirectly, COVID-19 AKI may stem from sepsis, volume depletion, and administration ...

Abstract	Coronavirus disease-19 (COVID-19), caused by severe acute respiratory syndrome Coronavirus- 2 (SARS-CoV-2), has caused a global pandemic with high morbidity and mortality. The presence of several comorbidities has been associated with a worse prognosis, with chronic kidney disease being a critical risk factor. Regarding COVID-19 complications, other than classical pneumonia and thromboembolism, acute kidney injury (AKI) is highly prevalent and represents a poor prognostic indicator linked to increased disease severity and mortality. Its pathophysiology is multifactorial, revolving around inflammation, endothelial dysfunction, and activation of coagulation, while the direct viral insult of the kidney remains a matter of controversy. Indirectly, COVID-19 AKI may stem from sepsis, volume depletion, and administration of nephrotoxic agents, among others. Several markers have been proposed for the early detection of COVID-19 AKI, including blood and urinary inflammatory and kidney injury biomarkers, while urinary SARS-CoV-2 load may also be an early prognostic sign. Concerning renal replacement therapy (RRT), general principles apply to COVID-19 AKI, but sudden RRT surges may mandate adjustments in resources. Following an episode of COVID-19 AKI, there is a gradual recovery of kidney function, with pre-existing renal impairment and high serum creatinine at discharge being associated with kidney disease progression and long-term dialysis dependence. Finally, kidney transplant recipients represent a special patient category with increased susceptibility to COVID- 19 and subsequent high risk of severe disease progression. Rates of mortality, AKI, and graft rejection are significantly elevated in the presence of COVID-19, highlighting the need for prevention and careful management of the disease in this subgroup.
MeSH term(s)	Humans ; COVID-19/complications ; SARS-CoV-2 ; Pandemics ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Disease Progression
Language	English
Publishing date	2022-05-11
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2192362-0
ISSN	1875-6212 ; 1570-1611
ISSN (online)	1875-6212
ISSN	1570-1611
DOI	10.2174/1570161120666220513103007
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Zs.A 6282: Show issues

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Article ; Online: Coronavirus Disease 2019 and the Kidney

Ajay Jaryal / Sanjay Vikrant

Saudi Journal of Kidney Diseases and Transplantation, Vol 32, Iss 5, Pp 1220-

2021 Volume 1234

Abstract	Coronaviruses are ubiquitous pathogens and have caused epidemics in the recent past. Coupled with globalization, they have the potential to transform into the pandemic, as is the case of coronavirus disease 2019 (COVID-19). Primarily to start as a respiratory illness, they are known to cause systemic disease and affect many organ systems. Due to the lack of, universally proven, specific anti-viral therapy, the mainstay of treatment is “supportive care” and some of the patients afflicted with it, require intensive care and organ support for lungs and/or kidneys. Patients with the diseases of the kidney, particularly those on dialysis and kidney transplant recipients, are predisposed to the worst outcomes with COVID-19. It also leads to acute kidney injury, which is an important and independent determinant of prognosis in these patients. It also creates a huge demand for the delivery of renal replacement therapy. COVID-19 is an emerging and evolving disease, and so, it is important to understand the mechanism and management of kidney diseases in COVID-19.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID-19 and the Kidney

Ida Gagliardi / Gemma Patella / Ashour Michael / Raffaele Serra / Michele Provenzano / Michele Andreucci

Journal of Clinical Medicine, Vol 9, Iss 2506, p

From Epidemiology to Clinical Practice

2020 Volume 2506

Abstract: ... transplantation) and prevention and containment strategies. Although there remains much more to be learned ... infection and the role of the virus in the development and progression of kidney damage. In this article ... attention is focused on the epidemiology, etiology and pathophysiological mechanisms of kidney damage ...

Abstract	The new respiratory infectious disease coronavirus disease 2019 (COVID-19) that originated in Wuhan, China, in December 2019 and caused by a new strain of zoonotic coronavirus, named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), to date has killed over 630,000 people and infected over 15,000,000 worldwide. Most of the deceased patients had pre-existing comorbidities; over 20% had chronic kidney disease (CKD). Furthermore, although SARS-CoV-2 infection is characterized mainly by diffuse alveolar damage and acute respiratory failure, acute kidney injury (AKI) has developed in a high percentage of cases. As AKI has been shown to be associated with worse prognosis, we believe that the impact of SARS-CoV-2 on the kidney should be investigated. This review sets out to describe the main renal aspects of SARS-CoV-2 infection and the role of the virus in the development and progression of kidney damage. In this article, attention is focused on the epidemiology, etiology and pathophysiological mechanisms of kidney damage, histopathology, clinical features in nephropathic patients (CKD, hemodialysis, peritoneal dialysis, AKI, transplantation) and prevention and containment strategies. Although there remains much more to be learned with regards to this disease, nonetheless it is our hope that this review will aid in the understanding and management of SARS-CoV-2 infection.
Keywords	SARS-CoV-2 ; acute kidney injury ; dialysis ; renal transplantation ; pandemic ; Medicine ; R ; covid19
Subject code	610
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article: COVID-19 and the Kidney: From Epidemiology to Clinical Practice.

Gagliardi, Ida / Patella, Gemma / Michael, Ashour / Serra, Raffaele / Provenzano, Michele / Andreucci, Michele

Journal of clinical medicine

2020 Volume 9, Issue 8

Abstract	The new respiratory infectious disease coronavirus disease 2019 (COVID-19) that originated in Wuhan, China, in December 2019 and caused by a new strain of zoonotic coronavirus, named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), to date has killed over 630,000 people and infected over 15,000,000 worldwide. Most of the deceased patients had pre-existing comorbidities; over 20% had chronic kidney disease (CKD). Furthermore, although SARS-CoV-2 infection is characterized mainly by diffuse alveolar damage and acute respiratory failure, acute kidney injury (AKI) has developed in a high percentage of cases. As AKI has been shown to be associated with worse prognosis, we believe that the impact of SARS-CoV-2 on the kidney should be investigated. This review sets out to describe the main renal aspects of SARS-CoV-2 infection and the role of the virus in the development and progression of kidney damage. In this article, attention is focused on the epidemiology, etiology and pathophysiological mechanisms of kidney damage, histopathology, clinical features in nephropathic patients (CKD, hemodialysis, peritoneal dialysis, AKI, transplantation) and prevention and containment strategies. Although there remains much more to be learned with regards to this disease, nonetheless it is our hope that this review will aid in the understanding and management of SARS-CoV-2 infection.
Keywords	covid19
Language	English
Publishing date	2020-08-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm9082506
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Article: How COVID-19 crisis influenced kidney transplant recipients in Slovakia.

Zilinska, Zuzana / Chrastina, Martin / Zitnakova, Marcela / Lackova, Eva / Cellar, Marcel / Bena, Luboslav / Baltesova, Tatiana / Rosenberger, Jaroslav / Granak, Karol / Vnucak, Matej / Dedinska, Ivana / Breza, Jan

Bratislavske lekarske listy

2022 Volume 123, Issue 5, Page(s) 315–321

Abstract: ... in the haemodialysis program had a worse prognosis (Tab. 5, Fig. 1, Ref. 21) Keywords: COVID-19, kidney transplantation ... Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries. Patients ... on the parameters preceding the infection. We compared morbidity and mortality from COVID-19 before and after ...

Abstract	Objectives: The aim of our analysis was to evaluate the impact of the COVID-19 pandemic on the procurement program and kidney transplantation in Slovakia and to identify the risk factors for a severe course of COVID-19 disease, as well as the risk factors for COVID-19 fatalities, with the focus on the parameters preceding the infection. We compared morbidity and mortality from COVID-19 before and after the spread of the alpha variant of the virus and the same among transplant (KTRs) and haemodialysis patients in Slovakia. Methods: 305 KTRs (68.8 % males) with confirmed SARS-CoV-2 positivity were included in the multicentric retrospective analysis. The patients were split into subgroups based on the time of falling ill and their clinical course. Results: The procurement program and kidney transplants in Slovakia dropped in the observed period by 28.6 % (p<0.0001) and by 33.5 % (p<0.0001) respectively. Age over 59 years (p=0.0088) and diabetes mellitus (p=0.0106) were identified as independent risk factors for severe course of the disease. Risk factors for death were the age over 59 years (p=0.0003) and graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0029). The prevalence of the alpha variant in Slovakia was associated with a severe course in KTRs treated with corticoids (p=0.0273) and in graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0076); the risk of death was higher in KTRs over 59 years (p=0.0173) and again with CKD-EPI<0.5 mL/s (p=0.0393). KTRs had a 3.7 times lower risk of infection compared to the haemodialysis patients (p<0.0001), with mortality of 9.8 % vs 30 % (p<0.0001). Conclusion: The procurement and transplant program is sustainable even during a pandemic, provided that measures are set up quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries. Patients in the haemodialysis program had a worse prognosis (Tab. 5, Fig. 1, Ref. 21) Keywords: COVID-19, kidney transplantation, dialysis, immunosuppression, obesity, diabetes mellitus.
MeSH term(s)	COVID-19/epidemiology ; Female ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Pandemics ; Renal Insufficiency, Chronic ; Retrospective Studies ; SARS-CoV-2 ; Slovakia/epidemiology
Language	English
Publishing date	2022-04-14
Publishing country	Slovakia
Document type	Journal Article
ZDB-ID	127421-1
ISSN	0006-9248
ISSN	0006-9248
DOI	10.4149/BLL_2022_049
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Article: COVID-19 and the kidney: A South African state healthcare experience.

Jones, Erika S W / Davidson, Bianca J / Barday, Zibya / Barday, Zunaid / Davids, M Razeen / Thomson, David / Day, Christel Arnold / Hussey, Hannah / Vermeulen, Alda / Chothia, Mogamat-Yazied / Nel, Johan / Wearne, Nicola

Clinical nephrology

2021 Volume 95, Issue 4, Page(s) 171–181

Abstract: ... were documented and 2,323 deaths reported. COVID-19 can have multisystem involvement ... kidney replacement therapy, a better prognosis than anticipated was found in our chronic dialysis cohort, and high numbers ... with AKI. We also reviewed our chronic dialysis cohort and renal transplant recipients who tested positive ...

Abstract	The first documented case of SARS-CoV-2 infection was confirmed in South Africa (SA) in March 2020. The Western Cape (WC) province was the initial epicenter. The pandemic peaked in July 2020 when 76,851 cases were documented and 2,323 deaths reported. COVID-19 can have multisystem involvement. Acute kidney injury (AKI) is well-documented and associated with increased mortality. We report our experience as the pandemic evolved in the WC province, focusing on those patients with a SARS-CoV-2 positive test presenting with AKI. We also reviewed our chronic dialysis cohort and renal transplant recipients who tested positive to assess incidence and outcomes. All patients presenting to nephrology services at the four main public hospitals were included. Information regarding demographics, co-morbidities, medical care, laboratory data, and outcomes were recorded. There were 86 patients referred with AKI, 48 required dialysis, and 47 died. There were 52 patients admitted to the intensive care unit with AKI (37 received dialysis, 1 of whom survived). In those presenting with AKI, diabetes, obesity, hypertension, and HIV were the most common comorbidities. Of the 295 patients receiving chronic dialysis within our services, 31 tested positive for SARS-CoV-2, and 6 died. Of the 45 kidney transplant recipients who tested positive, 9 died. Only 3 required dialysis. In conclusion, we report a high rate of AKI and poor prognosis in those requiring kidney replacement therapy, a better prognosis than anticipated was found in our chronic dialysis cohort, and high numbers of admissions were required for renal transplant recipients.
MeSH term(s)	Acute Kidney Injury/etiology ; Acute Kidney Injury/physiopathology ; Acute Kidney Injury/therapy ; COVID-19/complications ; COVID-19/physiopathology ; Hospitalization ; Humans ; Intensive Care Units ; Kidney/physiopathology ; Pandemics ; Prognosis ; Renal Replacement Therapy ; South Africa
Language	English
Publishing date	2021-02-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	185101-9
ISSN	0301-0430
ISSN	0301-0430
DOI	10.5414/CN110390
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Zs.A 873: Show issues

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Article ; Online: Kidney Transplantation in the Times of COVID-19 - A Literature Review.

Imam, Ashraf / Abukhalaf, Sadi A / Imam, Riham / Abu-Gazala, Samir / Merhav, Hadar / Khalaileh, Abed

Annals of transplantation

2020 Volume 25, Page(s) e925755

Abstract: Kidney transplantation at the time of the COVID-19 pandemic is challenging. Modifying ... Acute kidney injury was observed in 34.1% of patients. Kidney transplant patients encountered COVID-19 were maintained ... literature of kidney transplant recipients who encountered COVID-19. A literature review was performed using ...

Abstract	Kidney transplantation at the time of the COVID-19 pandemic is challenging. Modifying the immunosuppression protocols is controversial and not evidence based. In this study, we aim to review the published literature of kidney transplant recipients who encountered COVID-19. A literature review was performed using PubMed, ScienceDirect, and World Health Organization databases to identify relevant English-language articles published up to May 7, 2020. There were 24 articles that reported 129 kidney transplant recipients who encountered COVID-19. The age mean was 54.2 years with 73.7% as males. The most commonly reported presentations in order were fever (82.3%), cough (58%), shortness of breath (33.2%), and fatigue (30.7%). Acute kidney injury was observed in 34.1% of patients. Kidney transplant patients encountered COVID-19 were maintained on tacrolimus (Tac, 92%), mycophenolate mofetil (MMF, 78.8%), and prednisone (Pred, 77%) and were manage by holding MMF in 79.1% of patients and holding Tac in 34.4% of patients. In all, 20% of patients needed Intensive Care Unit (ICU) admission and 24.6% of patients required mechanical ventilation. In all, 18.8% of patients had died compared to the reported general population COVID-19 mortality of 3.4%. The clinical presentation of COVID-19 in kidney transplant recipients may be different from the general population with a higher rate of severe disease, complications including renal failure, and mortality.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/surgery ; Adult ; COVID-19 ; Cause of Death ; Coronavirus Infections/epidemiology ; Databases, Factual ; Female ; Global Health ; Graft Survival ; Humans ; Immunosuppression Therapy/methods ; Incidence ; Infection Control/methods ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/methods ; Kidney Transplantation/mortality ; Kidney Transplantation/statistics & numerical data ; Male ; Middle Aged ; Pandemics/statistics & numerical data ; Patient Selection ; Pneumonia, Viral/epidemiology ; Prognosis ; Risk Assessment ; Survival Analysis ; World Health Organization
Keywords	covid19
Language	English
Publishing date	2020-07-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1484710-3
ISSN	2329-0358 ; 1425-9524
ISSN (online)	2329-0358
ISSN	1425-9524
DOI	10.12659/AOT.925755
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