ABSTRACT
Purpose: We describe short-term outcomes as well as peri- and post-transplant complications in patients with prior coronavirus disease 2019 (COVID-19) who subsequently underwent kidney transplantation. Methods: This was a single-center, retrospective cohort study of all recipients of isolated living- or deceased-donor kidney transplants between 4/1/2020-10/1/2020. Patients with prior PCR confirmed COVID-19 were considered candidates for kidney transplantation if they were at least 4 weeks post-infection, had resolution of symptoms, and had one negative nasopharyngeal PCR swab specimen. Standard doses of induction and maintenance immunosuppression were administered at the time of transplant and included anti-thymocyte globulin, tacrolimus, mycophenolate, and tapering corticosteroids. Patients were followed from the date of transplantation until study conclusion (11/1/2020), to compare short-term patient and allograft outcomes between those with prior COVID-19 and COVID-19 naïve controls transplanted during the same time-period. Results: 81 patients received isolated kidney transplants during the review period, 13 (16.0%) of whom had recovered from prior COVID-19 infection. The median time between COVID-19 diagnosis and transplantation was 71 (IQR=56.5-135) days, and all 10 patients who were tested had evidence of significant antibody titers to the SARS-CoV-2 spike protein. The majority of patients had mild disease (69.2%), while 3 patients required hospital admission and supplemental oxygen, and 1 patient required mechanical ventilation. Baseline characteristics were similar between COVID-19 positive and negative patients, with the exception of more Hispanic/ Latino patients in the prior COVID-19 group (53.8% vs 17.6%;p<0.01). At study conclusion, after a median follow-up of 3.6 months, patient and allograft survival were similar between COVID-19 positive and negative patients (92.3%/92.3% vs 100.0%/98.5%), and mean baseline serum creatinine was 1.5 mg/dL in both groups. One patient with prior mild COVID-19 died due to a pulmonary embolism within 1-month of transplant;however, no differences were observed in the overall rate of thromboembolism (7.7% vs 4.4%;p=0.61). Index hospital length of stay and readmission rate within 30-days of transplant were also similar between groups, but patients with prior COVID-19 did have a higher incidence of delayed extubation posttransplant (15.4% vs 1.5%;p=0.02). No cases of COVID-19 re-infection or biopsy proven allograft rejection were observed among patients with prior COVID-19. Conclusions: In our preliminary experience, patients with prior COVID-19 infection appeared to have similar short-term outcomes when compared with COVID-19 naive patients. We did observe a potential signal for increased peri-operative respiratory complications in patients with prior COVID-19, which may warrant additional monitoring and further study in multi-center cohorts.
ABSTRACT
The introduction defines “media ventriloquism” and explains its value in an era wherein interactions are increasingly mediated. The political stakes of the project are high, particularly when the world is witnessing technological manipulation on a grand scale, yet the theoretical lens used in this volume allows the authors to approach ventriloquism from a number of disciplines and apply it to texts from nineteenth-century spiritualism to early Hollywood talkies to Korean video games. The introduction explains how the chapters are organized into sections and coins two new terms that unify their focus: the “technovocalic body, " which builds on Steven Connor’s idea of the vocalic body, and the “screen voice, " which is rooted in Sigmund Freud’s discussion of the screen memory. To explain these terms, the chapter turns to recent films by Spike Lee and Boots Riley and also references classics such as Singin’ in the Rain and Julie Dash’s Illusions. © Oxford University Press 2021.