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1.
J Med Internet Res ; 22(10): e22068, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: covidwho-863364

RESUMEN

BACKGROUND: The COVID-19 pandemic has markedly affected renal transplant care. During this time of social distancing, limited in-person visits, and uncertainty, patients and donors are relying more than ever on telemedicine and web-based information. Several factors can influence patients' understanding of web-based information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building). OBJECTIVE: The aim of this study was to systemically evaluate the content, delivery modes, and social-epistemological dimensions of web-based information on COVID-19 and renal transplantation at time of the pandemic. METHODS: Multiple keyword combinations were used to retrieve websites on COVID-19 and renal transplantation using the search engines Google.com and Google.nl. From 14 different websites, 30 webpages were examined to determine their organizational sources, topics, delivery modes, and social-epistemological dimensions. RESULTS: The variety of topics and delivery modes was limited. A total of 13 different delivery modes were encountered, of which 8 (62%) were instructional and 5 (38%) were interactional; no assessment delivery modes were observed. No website offered all available delivery modes. The majority of delivery modes (8/13, 62%) focused on individual and passive learning, whereas group learning and active construction of knowledge were rarely encountered. CONCLUSIONS: By taking interactive knowledge transfer into account, the educational quality of eHealth for transplant care could increase, especially in times of crisis when rapid knowledge transfer is needed.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Internet , Trasplante de Riñón , Conocimiento , Donadores Vivos/educación , Educación del Paciente como Asunto , Neumonía Viral/epidemiología , Telemedicina , Betacoronavirus , Humanos , Pandemias , Educación del Paciente como Asunto/normas , Educación del Paciente como Asunto/estadística & datos numéricos , Motor de Búsqueda , Incertidumbre
2.
Nephron ; 144(5): 213-221, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-829878

RESUMEN

Here, we review the most recent findings on the effects of SARS-CoV-2 infection on kidney diseases, including acute kidney injury, and examine the potential effects of ARBs on the outcomes of patients with COVID-19. Lastly, we discuss the clinical management of COVID-19 patients with existing chronic renal disorders, particularly those in dialysis and with kidney transplants.


Asunto(s)
Angiotensinas/antagonistas & inhibidores , Infecciones por Coronavirus/complicaciones , Enfermedades Renales/complicaciones , Enfermedades Renales/tratamiento farmacológico , Neumonía Viral/complicaciones , Antagonistas de Receptores de Angiotensina , Inhibidores de la Enzima Convertidora de Angiotensina , Betacoronavirus/fisiología , Humanos , Riñón/virología , Trasplante de Riñón , Nefrólogos , Pandemias , Peptidil-Dipeptidasa A , Diálisis Renal , Replicación Viral
3.
BMC Nephrol ; 21(1): 419, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: covidwho-810425

RESUMEN

BACKGROUND: Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing KRT in Scotland. METHODS: Study design was an observational cohort study. Data were linked between the Scottish Renal Registry, Health Protection Scotland and the Scottish Intensive Care Society Audit Group national data sets using a unique patient identifier (Community Health Index (CHI)) for each individual by the Public Health and Intelligence unit of Public Health, Scotland. Descriptive statistics and survival analyses were performed. RESULTS: During the period 1st March 2020 to 31st May 2020, 110 patients receiving KRT tested positive for SARS-CoV-2 amounting to 2% of the prevalent KRT population. Of those affected, 86 were receiving haemodialysis or peritoneal dialysis and 24 had a renal transplant. Patients who tested positive were older and more likely to reside in more deprived postcodes. Mortality was high at 26.7% in the dialysis patients and 29.2% in the transplant patients. CONCLUSION: The rate of detected SARS-CoV-2 in people receiving KRT in Scotland was relatively low but with a high mortality for those demonstrating infection. Although impossible to confirm, it appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus , Fallo Renal Crónico , Trasplante de Riñón/estadística & datos numéricos , Pandemias , Neumonía Viral , Terapia de Reemplazo Renal , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/cirugía , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Mortalidad , Evaluación de Procesos y Resultados en Atención de Salud , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Salud Pública/métodos , Sistema de Registros/estadística & datos numéricos , Terapia de Reemplazo Renal/métodos , Terapia de Reemplazo Renal/estadística & datos numéricos , Escocia/epidemiología
4.
J Urol ; 204(3): 607-608, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-804831
5.
BMC Infect Dis ; 20(1): 707, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: covidwho-795366

RESUMEN

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus-2 has spread rapidly worldwide and disease spread is currently increasing. Data on the clinical picture of transplant recipients and management of the anti-rejection immunosuppressive therapy on COVID-19 infection are lacking. CASE PRESENTATION: We report two cases of COVID-19 infection in renal transplant recipients with variable clinical presentations. The first patient presented with mild respiratory symptoms and a stable clinical course. The second patient had more severe clinical characteristics and presented with severe pneumonia and multi-organ failure. Both patients received a combination therapy including antiviral treatment and reduced immunosuppression therapy and finally recovered. CONCLUSIONS: We report COVID-19 infection in two renal transplant recipients with a favorable outcome but different clinical courses, which may provide a reference value for treating such patients.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Trasplante de Riñón , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Antivirales/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Receptores de Trasplantes , Resultado del Tratamiento
7.
J Med Internet Res ; 22(10): e22068, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: covidwho-781818

RESUMEN

BACKGROUND: The COVID-19 pandemic has markedly affected renal transplant care. During this time of social distancing, limited in-person visits, and uncertainty, patients and donors are relying more than ever on telemedicine and web-based information. Several factors can influence patients' understanding of web-based information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building). OBJECTIVE: The aim of this study was to systemically evaluate the content, delivery modes, and social-epistemological dimensions of web-based information on COVID-19 and renal transplantation at time of the pandemic. METHODS: Multiple keyword combinations were used to retrieve websites on COVID-19 and renal transplantation using the search engines Google.com and Google.nl. From 14 different websites, 30 webpages were examined to determine their organizational sources, topics, delivery modes, and social-epistemological dimensions. RESULTS: The variety of topics and delivery modes was limited. A total of 13 different delivery modes were encountered, of which 8 (62%) were instructional and 5 (38%) were interactional; no assessment delivery modes were observed. No website offered all available delivery modes. The majority of delivery modes (8/13, 62%) focused on individual and passive learning, whereas group learning and active construction of knowledge were rarely encountered. CONCLUSIONS: By taking interactive knowledge transfer into account, the educational quality of eHealth for transplant care could increase, especially in times of crisis when rapid knowledge transfer is needed.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Internet , Trasplante de Riñón , Conocimiento , Donadores Vivos/educación , Educación del Paciente como Asunto , Neumonía Viral/epidemiología , Telemedicina , Betacoronavirus , Humanos , Pandemias , Educación del Paciente como Asunto/normas , Educación del Paciente como Asunto/estadística & datos numéricos , Motor de Búsqueda , Incertidumbre
11.
Am J Transplant ; 20(9): 2599-2601, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-760102

RESUMEN

The COVID-19 pandemic is spreading worldwide and the impact of the disease in transplant patients is evolving. In this case report, we presented a 63-year-old female kidney transplant recipient who presented with dyspnea and cough and was diagnosed with COVID-19 pneumonia. On the fourth day of admission, the patient's condition worsened. Therefore, the immunosuppressive medications were discontinued, and hydrocortisone was started. The patient died on the fifth day.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Rechazo de Injerto/prevención & control , Fallo Renal Crónico/complicaciones , Trasplante de Riñón/métodos , Neumonía Viral/complicaciones , Receptores de Trasplantes , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Inmunosupresión/métodos , Fallo Renal Crónico/cirugía , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología
13.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 495-500, 2020 May 28.
Artículo en Inglés, Chino | MEDLINE | ID: covidwho-745315

RESUMEN

OBJECTIVES: To summarize the emergency management of the kidney transplantation for a large tertiary first-class hospital in response to the epidemic of coronavirus disease 2019 (COVID-19). METHODS: The clinical data of inpatients in the Department of Kidney Transplantation from January 24, 2020 to February 29, 2020 were retrospectively analyzed. Since the outbreak of COVID-19, we conducted telephone, Wechat follow-up, and online education for kidney transplant recipients and patients on waiting-list for kidney transplantation one by one. We also strictly screened for COVID-19 in outpatients. To guarantee the security of medical staff and recipients and to reduce the transmission risk of COVID-19, we have made detailed approaches to prevent COVID-19, which mainly included 6 aspects of preventive approaches, such as kidney transplant clinic, kidney transplant ward, patients on waiting-list for kidney transplantation, kidney transplant operation, medical staff self-protection, and postoperative follow-up of kidney transplant recipients. RESULTS: There were altogether 47 inpatients which included 20 recipients who had just received kidney transplantation in the meantime, 2 577 kidney transplant recipients, 1 689 patients on waiting-list for kidney transplantation, and 794 outpatients in our hospital. No case of COVID-19 occurred in this period. CONCLUSIONS: Through strictly implementing proactive and preventive approaches, we avoid the occurrence of COVID-19 in carrying out kidney transplantation in the epidemic period.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Trasplante de Riñón , Neumonía Viral/epidemiología , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Estudios Retrospectivos , Centros de Atención Terciaria , Receptores de Trasplantes , Listas de Espera
14.
J Bras Nefrol ; 42(2 suppl 1): 32-35, 2020 Aug 26.
Artículo en Inglés, Portugués | MEDLINE | ID: covidwho-740463

RESUMEN

INTRODUCTION: The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. METHODS: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. RESULTS: We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. DISCUSSION: Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Enfermedades Renales/terapia , Neumonía Viral/epidemiología , Terapia de Reemplazo Renal/normas , Adolescente , Atención Ambulatoria , Brasil/epidemiología , Niño , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Humanos , Higiene/normas , Trasplante de Riñón , Máscaras , Nefrología/normas , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Aislamiento de Pacientes , Pediatría , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Terapia de Reemplazo Renal/métodos , Sociedades Médicas , Evaluación de Síntomas , Transporte de Pacientes
15.
J Urol ; 204(3): 607-608, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-735827
17.
J Am Soc Nephrol ; 31(10): 2413-2423, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-732955

RESUMEN

BACKGROUND: COVID-19 has been associated with high morbidity and mortality in kidney transplant recipients. However, risk factors for COVID-19 disease in patients with kidney transplants remain poorly defined. METHODS: We enrolled patients who underwent kidney transplantation and were actively followed up in two hospitals in Paris on March 1st, 2020. Patients were screened for baseline and transplant characteristics, functional parameters, comorbidities, and immunosuppressive therapies. COVID-19 disease was assessed. Patients were followed up during the pandemic until April 30th, 2020 by the COVID-19 SLS KT survey program, including teleconsulting, at-home monitoring for patients with COVID-19, and a dedicated phone hotline platform. RESULTS: Among 1216 patients with kidney transplants enrolled, 66 (5%) patients were identified with COVID-19 disease, which is higher than the incidence observed in the general population in France (0.3%). Their mean age was 56.4±12.5 years, and 37 (56%) patients were men. The following factors were independently associated with COVID-19 disease: non-White ethnicity (adjusted odds ratio [OR], 2.17; 95% confidence interval [95% CI], 1.23 to 3.78; P=0.007), obesity (OR, 2.19; 95% CI, 1.19 to 4.05; P=0.01), asthma and chronic pulmonary disease (OR, 3.09; 95% CI, 1.49 to 6.41; P=0.002), and diabetes (OR, 3.33; 95% CI, 1.92 to 5.77; P<0.001). The mortality rate related to COVID-19 disease was 1% in the overall study population and 24% in COVID-19-positive patients. CONCLUSIONS: Patients with kidney transplants display a high risk of mortality. Non-White ethnicity and comorbidities such as obesity, diabetes, asthma, and chronic pulmonary disease were associated with higher risk of developing COVID-19 disease. It is imperative that policy makers urgently ensure the integration of such risk factors on response operations against COVID-19.


Asunto(s)
Comorbilidad , Infecciones por Coronavirus/epidemiología , Huésped Inmunocomprometido/inmunología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud , Neumonía Viral/epidemiología , Adulto , Anciano , Estudios de Cohortes , Infecciones por Coronavirus/prevención & control , Femenino , Francia , Humanos , Incidencia , Control de Infecciones/organización & administración , Fallo Renal Crónico/epidemiología , Trasplante de Riñón/mortalidad , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Neumonía Viral/prevención & control , Estudios Prospectivos , Medición de Riesgo , Análisis de Supervivencia , Receptores de Trasplantes/estadística & datos numéricos
18.
Am J Case Rep ; 21: e926464, 2020 Aug 16.
Artículo en Inglés | MEDLINE | ID: covidwho-721634

RESUMEN

BACKGROUND Although coronavirus disease 2019 (COVID-19) manifests primarily as a lung infection, its involvement in acute kidney injury (AKI) is gaining recognition and is associated with increased morbidity and mortality. Concurrent infection, which may require administration of a potentially nephrotoxic agent, can worsen AKI and lead to poor outcomes. Stenotrophomonas maltophilia is a multidrug-resistant gram-negative bacillus associated with nosocomial infections, especially in severely immunocompromised and debilitated patients. Trimethoprim/sulfamethoxazole combination (TMP/SMX) is considered the treatment of choice but can itself lead to AKI, posing a significant challenge in the management of patients with concomitant COVID-19 and S. maltophilia pneumonia. CASE REPORT A 64-year-old male with end-stage renal disease and post renal transplant presented with severe respiratory symptoms of COVID-19 and was intubated upon admission. His renal functions were normal at the time of admission. The patient subsequently developed superimposed bacterial pneumonia with S. maltophilia requiring administration of TMP/SMX. However, TMP/SMX led to the development of AKI, which continued to worsen despite appropriate management including hemodialysis. This coincided with and most likely resulted in the patient's clinical deterioration and ultimate death. CONCLUSIONS The etiology of kidney disease involvement in patients with COVID-19 is still evolving and appears to be multifactorial. The condition can significantly worsen especially when nephrotoxic agents are given, probably due to a cumulative or synergistic effect. Great caution should be taken when administering nephrotoxic agents in the setting of COVID-19 as it can lead to adverse patient outcomes.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Infecciones por Coronavirus/complicaciones , Infecciones por Bacterias Gramnegativas/complicaciones , Neumonía Bacteriana/microbiología , Neumonía Viral/complicaciones , Combinación Trimetoprim y Sulfametoxazol/efectos adversos , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Betacoronavirus , Deterioro Clínico , Coinfección , Infecciones por Coronavirus/tratamiento farmacológico , Resultado Fatal , Humanos , Huésped Inmunocomprometido , Trasplante de Riñón , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Bacteriana/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Stenotrophomonas maltophilia , Receptores de Trasplantes , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación
20.
J Investig Med High Impact Case Rep ; 8: 2324709620949307, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-708945

RESUMEN

The novel coronavirus disease has brought the world to standstill with high infectivity and rapid transmission. The disease caused by novel coronavirus is termed as coronavirus disease 2019 (COVID-19). We present the case of a renal transplant patient who was infected with COVID-19 through community spread and presented with fever and gastrointestinal symptoms. Transplant recipients are particularly vulnerable because of the immunosuppressed state. These patients can shed a virus for a prolonged period and can have a higher load of the virus. There have been no COVID-19 cases transmitted through organ donation. Preinfection immunological impairment can aggravate the severity of the infection. The transplant team plays a crucial role in donor and recipient evaluation and guiding the timing of the transplant. Although specific published data are lacking with regard to transplant recipients, they should follow the same precautions as the general population, like avoiding nonessential travel and practice social distancing.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Trasplante de Riñón/efectos adversos , Neumonía Viral/fisiopatología , Infecciones por Coronavirus/complicaciones , Diarrea/etiología , Fatiga/etiología , Femenino , Humanos , Persona de Mediana Edad , Trasplante de Órganos , Pandemias , Neumonía Viral/complicaciones , Receptores de Trasplantes
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