Author: Cravedi, Paolo; Mothi, Suraj S.; Azzi, Yorg; Haverly, Meredith; Farouk, Samira S.; Pérezâ€Sáez, MarÃa J.; Redondoâ€Pachón, Maria D.; Murphy, Barbara; Florman, Sander; Cyrino, Laura G.; Grafals, Monica; Venkataraman, Sandheep; Cheng, Xingxing S.; Wang, Aileen X.; Zaza, Gianluigi; Ranghino, Andrea; Furian, Lucrezia; Manrique, Joaquin; Maggiore, Umberto; Gandolfini, Ilaria; Agrawal, Nikhil; Patel, Het; Akalin, Enver; Riella, Leonardo V.
Title: COVIDâ€19 and kidney transplantation: Results from the TANGO International Transplant Consortium Cord-id: p2lwocse Document date: 2020_8_4
ID: p2lwocse
Snippet: Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVIDâ€19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVIDâ€19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through
Document: Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVIDâ€19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVIDâ€19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVIDâ€19 during the 9â€week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% were African American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), and heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%), and antivirals (14%). During a median followâ€up period of 52 days (IQR: 16â€66 days), acute kidney injury occurred in 52% cases, with respiratory failure requiring intubation in 29%, and the mortality rate was 32%. The 46 patients who died were older, had lower lymphocyte counts and estimated glomerular filtration rate levels, and had higher serum lactate dehydrogenase, procalcitonin, and interleukinâ€6 levels. In sum, hospitalized kidney transplant recipients with COVIDâ€19 have higher rates of acute kidney injury and mortality.
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