Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study
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 infection...
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| Veröffentlicht in: | Transplantation proceedings 2021-05, Vol.53 (4), p.1187-1193 |
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| creator | Hardesty, Anna Pandita, Aakriti Vieira, Kendra Rogers, Ralph Merhi, Basma Osband, Adena J. Aridi, Jad Shi, Yiyun Bayliss, George Cosgrove, Christopher Gohh, Reginald Morrissey, Paul Beckwith, Curt G. Farmakiotis, Dimitrios |
| description | 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.
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).
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. |
| doi_str_mv | 10.1016/j.transproceed.2021.01.002 |
| format | Article |
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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).
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.</description><identifier>ISSN: 0041-1345</identifier><identifier>ISSN: 1873-2623</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2021.01.002</identifier><identifier>PMID: 33573820</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Adult ; Aged ; Antiviral Agents - therapeutic use ; Case-Control Studies ; COVID-19 - complications ; COVID-19 - diagnosis ; COVID-19 - virology ; COVID-19 Drug Treatment ; Female ; Graft Rejection - prevention & control ; Humans ; Immunology ; Immunosuppressive Agents - therapeutic use ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Kidney Transplantation ; Length of Stay ; Life Sciences & Biomedicine ; Male ; Middle Aged ; Pandemics ; SARS-CoV-2 - isolation & purification ; Science & Technology ; Sirolimus - therapeutic use ; Surgery ; Tacrolimus - therapeutic use ; The Second COVID-19 Minisymposium ; TOR Serine-Threonine Kinases - metabolism ; Transplantation ; Treatment Outcome</subject><ispartof>Transplantation proceedings, 2021-05, Vol.53 (4), p.1187-1193</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021 Elsevier Inc. All rights reserved. 2021 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>9</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000656719000015</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c487t-a6aec11c930f57ec8b8272099a371e30eb1aa92d81874f138532448044043e8d3</citedby><cites>FETCH-LOGICAL-c487t-a6aec11c930f57ec8b8272099a371e30eb1aa92d81874f138532448044043e8d3</cites><orcidid>0000-0002-1496-0833 ; 0000-0001-7122-9273 ; 0000-0002-5519-4477 ; 0000-0002-8430-8111 ; 0000-0002-7175-2125 ; 0000-0001-8489-108X ; 0000-0003-0268-0188</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2021.01.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33573820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hardesty, Anna</creatorcontrib><creatorcontrib>Pandita, Aakriti</creatorcontrib><creatorcontrib>Vieira, Kendra</creatorcontrib><creatorcontrib>Rogers, Ralph</creatorcontrib><creatorcontrib>Merhi, Basma</creatorcontrib><creatorcontrib>Osband, Adena J.</creatorcontrib><creatorcontrib>Aridi, Jad</creatorcontrib><creatorcontrib>Shi, Yiyun</creatorcontrib><creatorcontrib>Bayliss, George</creatorcontrib><creatorcontrib>Cosgrove, Christopher</creatorcontrib><creatorcontrib>Gohh, Reginald</creatorcontrib><creatorcontrib>Morrissey, Paul</creatorcontrib><creatorcontrib>Beckwith, Curt G.</creatorcontrib><creatorcontrib>Farmakiotis, Dimitrios</creatorcontrib><title>Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study</title><title>Transplantation proceedings</title><addtitle>TRANSPL P</addtitle><addtitle>Transplant Proc</addtitle><description>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.
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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Case-Control Studies</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - virology</subject><subject>COVID-19 Drug Treatment</subject><subject>Female</subject><subject>Graft Rejection - prevention & control</subject><subject>Humans</subject><subject>Immunology</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidney Transplantation</subject><subject>Length of Stay</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pandemics</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Science & Technology</subject><subject>Sirolimus - therapeutic use</subject><subject>Surgery</subject><subject>Tacrolimus - therapeutic use</subject><subject>The Second COVID-19 Minisymposium</subject><subject>TOR Serine-Threonine Kinases - metabolism</subject><subject>Transplantation</subject><subject>Treatment Outcome</subject><issn>0041-1345</issn><issn>1873-2623</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNUdtu1DAQjRCILoVfQBZPSCjL-JLE6QNSlZaLqIREy7PldSbFq6wdbGdh_x63u6zKW6Wx7NGcc2bGpyjeUFhSoPX79TIF7eIUvEHslwwYXUIOYE-KBZUNL1nN-NNiASBoSbmoTooXMa4h50zw58UJ51XDJYNFYTsfvNNbG-ZILmxEHZEwoC2xjny1vcMdubnvNmqXyHc0drLoUjwj19bdjlh2OcNALv9MGHLFINGuJ13WKTvvUvAjuU5zv3tZPBv0GPHV4T4tfny8vOk-l1ffPn3pzq9KI2STSl1rNJSalsNQNWjkSrKGQdtq3lDkgCuqdct6mRcVA-Wy4kwICUKA4Ch7flp82OtO82qDvcnjBT2qKdiNDjvltVX_V5z9qW79VjWS14xBFnh7EAj-14wxqY2NBsf8AejnqJiQbT6SVRl6toea4GMMOBzbUFB3Xqm1euiVuvNKQQ5gmfz64aBH6j9zMkDuAb9x5Ydo7n_3CMtu1lXd0DY_gFadTTpZ7zo_u5Sp7x5PzeiLPRqzL1uLQR0YvQ1okuq9fcxCfwHRdM3V</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Hardesty, Anna</creator><creator>Pandita, Aakriti</creator><creator>Vieira, Kendra</creator><creator>Rogers, Ralph</creator><creator>Merhi, Basma</creator><creator>Osband, Adena J.</creator><creator>Aridi, Jad</creator><creator>Shi, Yiyun</creator><creator>Bayliss, George</creator><creator>Cosgrove, Christopher</creator><creator>Gohh, Reginald</creator><creator>Morrissey, Paul</creator><creator>Beckwith, Curt G.</creator><creator>Farmakiotis, Dimitrios</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1496-0833</orcidid><orcidid>https://orcid.org/0000-0001-7122-9273</orcidid><orcidid>https://orcid.org/0000-0002-5519-4477</orcidid><orcidid>https://orcid.org/0000-0002-8430-8111</orcidid><orcidid>https://orcid.org/0000-0002-7175-2125</orcidid><orcidid>https://orcid.org/0000-0001-8489-108X</orcidid><orcidid>https://orcid.org/0000-0003-0268-0188</orcidid></search><sort><creationdate>20210501</creationdate><title>Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study</title><author>Hardesty, Anna ; Pandita, Aakriti ; Vieira, Kendra ; Rogers, Ralph ; Merhi, Basma ; Osband, Adena J. ; Aridi, Jad ; Shi, Yiyun ; Bayliss, George ; Cosgrove, Christopher ; Gohh, Reginald ; Morrissey, Paul ; Beckwith, Curt G. ; Farmakiotis, Dimitrios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-a6aec11c930f57ec8b8272099a371e30eb1aa92d81874f138532448044043e8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Case-Control Studies</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - virology</topic><topic>COVID-19 Drug Treatment</topic><topic>Female</topic><topic>Graft Rejection - prevention & control</topic><topic>Humans</topic><topic>Immunology</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Kidney Transplantation</topic><topic>Length of Stay</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pandemics</topic><topic>SARS-CoV-2 - isolation & purification</topic><topic>Science & Technology</topic><topic>Sirolimus - therapeutic use</topic><topic>Surgery</topic><topic>Tacrolimus - therapeutic use</topic><topic>The Second COVID-19 Minisymposium</topic><topic>TOR Serine-Threonine Kinases - metabolism</topic><topic>Transplantation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hardesty, Anna</creatorcontrib><creatorcontrib>Pandita, Aakriti</creatorcontrib><creatorcontrib>Vieira, Kendra</creatorcontrib><creatorcontrib>Rogers, Ralph</creatorcontrib><creatorcontrib>Merhi, Basma</creatorcontrib><creatorcontrib>Osband, Adena J.</creatorcontrib><creatorcontrib>Aridi, Jad</creatorcontrib><creatorcontrib>Shi, Yiyun</creatorcontrib><creatorcontrib>Bayliss, George</creatorcontrib><creatorcontrib>Cosgrove, Christopher</creatorcontrib><creatorcontrib>Gohh, Reginald</creatorcontrib><creatorcontrib>Morrissey, Paul</creatorcontrib><creatorcontrib>Beckwith, Curt G.</creatorcontrib><creatorcontrib>Farmakiotis, Dimitrios</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hardesty, Anna</au><au>Pandita, Aakriti</au><au>Vieira, Kendra</au><au>Rogers, Ralph</au><au>Merhi, Basma</au><au>Osband, Adena J.</au><au>Aridi, Jad</au><au>Shi, Yiyun</au><au>Bayliss, George</au><au>Cosgrove, Christopher</au><au>Gohh, Reginald</au><au>Morrissey, Paul</au><au>Beckwith, Curt G.</au><au>Farmakiotis, Dimitrios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study</atitle><jtitle>Transplantation proceedings</jtitle><stitle>TRANSPL P</stitle><addtitle>Transplant Proc</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>53</volume><issue>4</issue><spage>1187</spage><epage>1193</epage><pages>1187-1193</pages><issn>0041-1345</issn><issn>1873-2623</issn><eissn>1873-2623</eissn><abstract>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.
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).
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.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>33573820</pmid><doi>10.1016/j.transproceed.2021.01.002</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1496-0833</orcidid><orcidid>https://orcid.org/0000-0001-7122-9273</orcidid><orcidid>https://orcid.org/0000-0002-5519-4477</orcidid><orcidid>https://orcid.org/0000-0002-8430-8111</orcidid><orcidid>https://orcid.org/0000-0002-7175-2125</orcidid><orcidid>https://orcid.org/0000-0001-8489-108X</orcidid><orcidid>https://orcid.org/0000-0003-0268-0188</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Antiviral Agents - therapeutic use Case-Control Studies COVID-19 - complications COVID-19 - diagnosis COVID-19 - virology COVID-19 Drug Treatment Female Graft Rejection - prevention & control Humans Immunology Immunosuppressive Agents - therapeutic use Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Kidney Transplantation Length of Stay Life Sciences & Biomedicine Male Middle Aged Pandemics SARS-CoV-2 - isolation & purification Science & Technology Sirolimus - therapeutic use Surgery Tacrolimus - therapeutic use The Second COVID-19 Minisymposium TOR Serine-Threonine Kinases - metabolism Transplantation Treatment Outcome |
| title | Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study |
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