COVID-19 in transplant recipients : The Spanish experience

© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons..

We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-β (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - Vol. 21, No. 5 (2021), p. 1825-1837

Language:

English

Contributors:

Coll, Elisabeth
Fernández-Ruiz, Mario
Sánchez-Álvarez, J Emilio
Martínez-Fernández, José R
Crespo, Marta
Gayoso, Jorge
Bada-Bosch, Teresa
Oppenheimer, Federico
Moreso, Francesc
López-Oliva, María O
Melilli, Edoardo
Rodríguez-Ferrero, Marisa L
Bravo, Carlos
Burgos, Elena
Facundo, Carme
Lorenzo, Inmaculada
Yañez, Íñigo
Galeano, Cristina
Roca, Ana
Cabello, Mercedes
Gómez-Bueno, Manuel
García-Cosío, MªDolores
Graus, Javier
Lladó, Laura
de Pablo, Alicia
Loinaz, Carmelo
Aguado, Beatriz
Hernández, Domingo
Domínguez-Gil, Beatriz
Spanish Group for the Study of COVID-19 in Transplant Recipients

Links:

Volltext

Keywords:

*Hematopoietic Stem Cell Transplantation
*Organ Transplantation
*Transplant Recipients
Antibiotic: antiviral
COVID-19
Clinical decision-making
Clinical research/practice
Complication: infectious
Female
Humans
Infection and infectious agents - viral
Infectious disease
Journal Article
Male
Middle Aged
SARS-CoV-2
Spain

Notes:

Date Completed 13.05.2021

Date Revised 13.05.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/ajt.16369

PMID:

33098200

PPN (Catalogue-ID):

NLM317648195