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
Hauptverfasser: 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
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container_end_page 754
container_issue 6
container_start_page 748
container_title European urology
container_volume 77
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
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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. 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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. 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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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