Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China
Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations. To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients. A total of 10 renal transplant recipients wi...
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Veröffentlicht in: | European urology 2020-06, Vol.77 (6), p.748-754 |
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creator | Zhu, Lan Gong, Nianqiao Liu, Bin Lu, Xia Chen, Dong Chen, Song Shu, Hongge Ma, Ke Xu, Xizhen Guo, Zhiliang Lu, Enfeng Chen, Dongrui Ge, Qinggang Cai, Junchao Jiang, Jipin Wei, Lai Zhang, Weijie Chen, Gang Chen, Zhishui |
description | Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations.
To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
Immunosuppressant reduction and low-dose methylprednisolone therapy.
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ± 9.3 vs 12.2 ± 4.6 d in the control group) and a longer course of illness (35.3 ± 8.3 vs 18.8 ± 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Immunosuppressed renal transplant recipients with coronavirus disease 2019 infection had more severe pneumonia than the general population. Most patients could recover following a treatment regimen consisting of reduced immunosuppressant use, low-dose methylprednisolone therapy, and protection of renal graft function. |
doi_str_mv | 10.1016/j.eururo.2020.03.039 |
format | Article |
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To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
Immunosuppressant reduction and low-dose methylprednisolone therapy.
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ± 9.3 vs 12.2 ± 4.6 d in the control group) and a longer course of illness (35.3 ± 8.3 vs 18.8 ± 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Immunosuppressed renal transplant recipients with coronavirus disease 2019 infection had more severe pneumonia than the general population. Most patients could recover following a treatment regimen consisting of reduced immunosuppressant use, low-dose methylprednisolone therapy, and protection of renal graft function.</description><identifier>ISSN: 0302-2838</identifier><identifier>ISSN: 1873-7560</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2020.03.039</identifier><identifier>PMID: 32317180</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Adult ; Aged ; Antiviral Agents - administration & dosage ; Antiviral Agents - adverse effects ; Betacoronavirus - drug effects ; Betacoronavirus - immunology ; Betacoronavirus - isolation & purification ; China ; Clinical Laboratory Techniques ; Coronavirus disease 2019 ; Coronavirus Infections - diagnosis ; Coronavirus Infections - drug therapy ; Coronavirus Infections - mortality ; Coronavirus Infections - virology ; COVID-19 ; COVID-19 Drug Treatment ; COVID-19 Testing ; Female ; Glucocorticoids - administration & dosage ; Glucocorticoids - adverse effects ; Humans ; Immunocompromised Host ; Immunosuppression ; Immunosuppressive Agents - administration & dosage ; Immunosuppressive Agents - adverse effects ; Infections ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney Transplantation - mortality ; Male ; Methylprednisolone - administration & dosage ; Methylprednisolone - adverse effects ; Middle Aged ; Noninvasive Ventilation ; Opportunistic Infections - drug therapy ; Opportunistic Infections - mortality ; Opportunistic Infections - therapy ; Opportunistic Infections - virology ; Outcome ; Oxygen Inhalation Therapy ; Pandemics ; Pneumonia ; Pneumonia, Viral - drug therapy ; Pneumonia, Viral - mortality ; Pneumonia, Viral - virology ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Time Factors ; Transplant Recipients ; Treatment Outcome ; Virus Shedding ; Young Adult</subject><ispartof>European urology, 2020-06, Vol.77 (6), p.748-754</ispartof><rights>2020 European Association of Urology</rights><rights>Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><rights>2020 European Association of Urology. Published by Elsevier B.V. All rights reserved. 2020 European Association of Urology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3789-16dde35ab1e6cf6331661c4e83b9ee78d4b573982d0d2133d2afb3bef4a322b3</citedby><cites>FETCH-LOGICAL-c3789-16dde35ab1e6cf6331661c4e83b9ee78d4b573982d0d2133d2afb3bef4a322b3</cites><orcidid>0000-0003-4752-4939 ; 0000-0003-0574-9785</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.eururo.2020.03.039$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32317180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Lan</creatorcontrib><creatorcontrib>Gong, Nianqiao</creatorcontrib><creatorcontrib>Liu, Bin</creatorcontrib><creatorcontrib>Lu, Xia</creatorcontrib><creatorcontrib>Chen, Dong</creatorcontrib><creatorcontrib>Chen, Song</creatorcontrib><creatorcontrib>Shu, Hongge</creatorcontrib><creatorcontrib>Ma, Ke</creatorcontrib><creatorcontrib>Xu, Xizhen</creatorcontrib><creatorcontrib>Guo, Zhiliang</creatorcontrib><creatorcontrib>Lu, Enfeng</creatorcontrib><creatorcontrib>Chen, Dongrui</creatorcontrib><creatorcontrib>Ge, Qinggang</creatorcontrib><creatorcontrib>Cai, Junchao</creatorcontrib><creatorcontrib>Jiang, Jipin</creatorcontrib><creatorcontrib>Wei, Lai</creatorcontrib><creatorcontrib>Zhang, Weijie</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Chen, Zhishui</creatorcontrib><title>Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China</title><title>European urology</title><addtitle>Eur Urol</addtitle><description>Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations.
To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
Immunosuppressant reduction and low-dose methylprednisolone therapy.
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ± 9.3 vs 12.2 ± 4.6 d in the control group) and a longer course of illness (35.3 ± 8.3 vs 18.8 ± 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Immunosuppressed renal transplant recipients with coronavirus disease 2019 infection had more severe pneumonia than the general population. Most patients could recover following a treatment regimen consisting of reduced immunosuppressant use, low-dose methylprednisolone therapy, and protection of renal graft function.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - administration & dosage</subject><subject>Antiviral Agents - adverse effects</subject><subject>Betacoronavirus - drug effects</subject><subject>Betacoronavirus - immunology</subject><subject>Betacoronavirus - isolation & purification</subject><subject>China</subject><subject>Clinical Laboratory Techniques</subject><subject>Coronavirus disease 2019</subject><subject>Coronavirus Infections - diagnosis</subject><subject>Coronavirus Infections - drug therapy</subject><subject>Coronavirus Infections - mortality</subject><subject>Coronavirus Infections - virology</subject><subject>COVID-19</subject><subject>COVID-19 Drug Treatment</subject><subject>COVID-19 Testing</subject><subject>Female</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - adverse effects</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Immunosuppression</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Infections</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney Transplantation - mortality</subject><subject>Male</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Methylprednisolone - adverse effects</subject><subject>Middle Aged</subject><subject>Noninvasive Ventilation</subject><subject>Opportunistic Infections - drug therapy</subject><subject>Opportunistic Infections - mortality</subject><subject>Opportunistic Infections - therapy</subject><subject>Opportunistic Infections - virology</subject><subject>Outcome</subject><subject>Oxygen Inhalation Therapy</subject><subject>Pandemics</subject><subject>Pneumonia</subject><subject>Pneumonia, Viral - drug therapy</subject><subject>Pneumonia, Viral - mortality</subject><subject>Pneumonia, Viral - virology</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><subject>Severity of Illness Index</subject><subject>Time Factors</subject><subject>Transplant Recipients</subject><subject>Treatment Outcome</subject><subject>Virus Shedding</subject><subject>Young Adult</subject><issn>0302-2838</issn><issn>1873-7560</issn><issn>1873-7560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UUuLFDEQDqK44-o_EMnRgz1WUv30ICzta2FB0QGPIZ2udjJMJ20yGfDsHzfDrKtehIJAqr5H1cfYUwFrAaJ-uVtTCin4tQQJa8Bc3T22Em2DRVPVcJ-tAEEWssX2gj2KcQcAWHX4kF2gRNGIFlbsZ--Dd_poQ4r8jY2kI3EJouOfHKXZO6u5dfx6npPzMS1LoBhp5J_J6T3fBO3istfukD-MXSy5Q3zFr_iXNM86_OB-4gJ4791kw5xhfaaPJ8KvaavdC95vrdOP2YNJ7yM9uX0v2ebd203_obj5-P66v7opDDZtV4h6HAkrPQiqzVQjiroWpqQWh46oacdyqBrsWjnCKAXiKPU04EBTqVHKAS_Z6zPtkobsxWSvQe_VEuzJqvLaqn87zm7VN39UTRYCbDLB81uC4L8nigc122hon_cnn6KS2GFdlhVCHi3Poyb4GANNdzIC1Ck-tVPn-NQpPgWYq8uwZ39bvAP9zuvPDpTvdLQUVDT56IZGG8gc1Ojt_xV-AXN-r74</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Zhu, Lan</creator><creator>Gong, Nianqiao</creator><creator>Liu, Bin</creator><creator>Lu, Xia</creator><creator>Chen, Dong</creator><creator>Chen, Song</creator><creator>Shu, Hongge</creator><creator>Ma, Ke</creator><creator>Xu, Xizhen</creator><creator>Guo, Zhiliang</creator><creator>Lu, Enfeng</creator><creator>Chen, Dongrui</creator><creator>Ge, Qinggang</creator><creator>Cai, Junchao</creator><creator>Jiang, Jipin</creator><creator>Wei, Lai</creator><creator>Zhang, Weijie</creator><creator>Chen, Gang</creator><creator>Chen, Zhishui</creator><general>Elsevier B.V</general><general>European Association of Urology. Published by Elsevier B.V</general><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/0000-0003-4752-4939</orcidid><orcidid>https://orcid.org/0000-0003-0574-9785</orcidid></search><sort><creationdate>20200601</creationdate><title>Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China</title><author>Zhu, Lan ; Gong, Nianqiao ; Liu, Bin ; Lu, Xia ; Chen, Dong ; Chen, Song ; Shu, Hongge ; Ma, Ke ; Xu, Xizhen ; Guo, Zhiliang ; Lu, Enfeng ; Chen, Dongrui ; Ge, Qinggang ; Cai, Junchao ; Jiang, Jipin ; Wei, Lai ; Zhang, Weijie ; Chen, Gang ; Chen, Zhishui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3789-16dde35ab1e6cf6331661c4e83b9ee78d4b573982d0d2133d2afb3bef4a322b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Lan</au><au>Gong, Nianqiao</au><au>Liu, Bin</au><au>Lu, Xia</au><au>Chen, Dong</au><au>Chen, Song</au><au>Shu, Hongge</au><au>Ma, Ke</au><au>Xu, Xizhen</au><au>Guo, Zhiliang</au><au>Lu, Enfeng</au><au>Chen, Dongrui</au><au>Ge, Qinggang</au><au>Cai, Junchao</au><au>Jiang, Jipin</au><au>Wei, Lai</au><au>Zhang, Weijie</au><au>Chen, Gang</au><au>Chen, Zhishui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China</atitle><jtitle>European urology</jtitle><addtitle>Eur Urol</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>77</volume><issue>6</issue><spage>748</spage><epage>754</epage><pages>748-754</pages><issn>0302-2838</issn><issn>1873-7560</issn><eissn>1873-7560</eissn><abstract>Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations.
To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
Immunosuppressant reduction and low-dose methylprednisolone therapy.
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ± 9.3 vs 12.2 ± 4.6 d in the control group) and a longer course of illness (35.3 ± 8.3 vs 18.8 ± 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Immunosuppressed renal transplant recipients with coronavirus disease 2019 infection had more severe pneumonia than the general population. Most patients could recover following a treatment regimen consisting of reduced immunosuppressant use, low-dose methylprednisolone therapy, and protection of renal graft function.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>32317180</pmid><doi>10.1016/j.eururo.2020.03.039</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4752-4939</orcidid><orcidid>https://orcid.org/0000-0003-0574-9785</orcidid><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; Elsevier ScienceDirect Journals Complete |
subjects | Adult Aged Antiviral Agents - administration & dosage Antiviral Agents - adverse effects Betacoronavirus - drug effects Betacoronavirus - immunology Betacoronavirus - isolation & purification China Clinical Laboratory Techniques Coronavirus disease 2019 Coronavirus Infections - diagnosis Coronavirus Infections - drug therapy Coronavirus Infections - mortality Coronavirus Infections - virology COVID-19 COVID-19 Drug Treatment COVID-19 Testing Female Glucocorticoids - administration & dosage Glucocorticoids - adverse effects Humans Immunocompromised Host Immunosuppression Immunosuppressive Agents - administration & dosage Immunosuppressive Agents - adverse effects Infections Kidney transplantation Kidney Transplantation - adverse effects Kidney Transplantation - mortality Male Methylprednisolone - administration & dosage Methylprednisolone - adverse effects Middle Aged Noninvasive Ventilation Opportunistic Infections - drug therapy Opportunistic Infections - mortality Opportunistic Infections - therapy Opportunistic Infections - virology Outcome Oxygen Inhalation Therapy Pandemics Pneumonia Pneumonia, Viral - drug therapy Pneumonia, Viral - mortality Pneumonia, Viral - virology Predictive Value of Tests Retrospective Studies Risk Factors SARS-CoV-2 Severity of Illness Index Time Factors Transplant Recipients Treatment Outcome Virus Shedding Young Adult |
title | Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China |
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