1. COVID-19 in solid organ transplant recipients: A single-center case series from Spain.
- Author
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Fernández-Ruiz M, Andrés A, Loinaz C, Delgado JF, López-Medrano F, San Juan R, González E, Polanco N, Folgueira MD, Lalueza A, Lumbreras C, and Aguado JM
- Subjects
- Aged, Antiviral Agents administration & dosage, Betacoronavirus, COVID-19, Drug Combinations, Female, Fever, Humans, Hydroxychloroquine administration & dosage, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Interferon-beta administration & dosage, Lopinavir administration & dosage, Male, Middle Aged, Pandemics, Radiography, Thoracic, Retrospective Studies, Ritonavir administration & dosage, SARS-CoV-2, Spain epidemiology, Coronavirus Infections complications, Coronavirus Infections mortality, Coronavirus Infections therapy, Organ Transplantation, Pneumonia, Viral complications, Pneumonia, Viral mortality, Pneumonia, Viral therapy, Transplant Recipients
- Abstract
The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon-β (16.7%). As of April 4, the case-fatality rate was 27.8% (5/18). After a median follow-up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C-reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS-CoV-2 infection has a severe course in SOT recipients., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2020
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