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Risk factors for unfavorable outcome and impact of early post-transplant infection in solid organ recipients with COVID-19: A prospective multicenter cohort study.
Salto-Alejandre, Sonsoles; Jiménez-Jorge, Silvia; Sabé, Nuria; Ramos-Martínez, Antonio; Linares, Laura; Valerio, Maricela; Martín-Dávila, Pilar; Fernández-Ruiz, Mario; Fariñas, María Carmen; Blanes-Juliá, Marino; Vidal, Elisa; Palacios-Baena, Zaira R; Hernández-Gallego, Román; Carratalá, Jordi; Calderón-Parra, Jorge; Ángeles Marcos, María; Muñoz, Patricia; Fortún-Abete, Jesús; Aguado, José María; Arnaiz-Revillas, Francisco; Blanes-Hernández, Rosa; de la Torre-Cisneros, Julián; López-Cortés, Luis E; García de Vinuesa-Calvo, Elena; Rosso, Clara M; Pachón, Jerónimo; Sánchez-Céspedes, Javier; Cordero, Elisa.
  • Salto-Alejandre S; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain.
  • Jiménez-Jorge S; Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain.
  • Sabé N; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain.
  • Ramos-Martínez A; Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain.
  • Linares L; Service of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
  • Valerio M; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Puerta de Hierro University Hospital, Madrid, Spain.
  • Martín-Dávila P; Service of Infectious Diseases, Clinic University Hospital, Barcelona, Spain.
  • Fernández-Ruiz M; Service of Clinical Microbiology and Infectious Diseases, Sanitary Research Institute, Gregorio Marañón University Hospital, Madrid, Spain.
  • Fariñas MC; Service of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain.
  • Blanes-Juliá M; Unit of Infectious Diseases, 12 de Octubre University Hospital, 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain.
  • Vidal E; Service of Infectious Diseases, Marqués de Valdecilla University Hospital, Marqués de Valdecilla-IDIVAL, University of Cantabria, Santander, Spain.
  • Palacios-Baena ZR; Section of Infectious Diseases, La Fe University Hospital, Valencia, Spain.
  • Hernández-Gallego R; Service of Infectious Diseases, Reina Sofía University Hospital, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.
  • Carratalá J; Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain.
  • Calderón-Parra J; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Virgen Macarena University Hospital, Seville, Spain.
  • Ángeles Marcos M; Unit of Kidney Transplant, Service of Nefrology, Badajoz University Hospital, Extremadura, Spain.
  • Muñoz P; Service of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
  • Fortún-Abete J; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Puerta de Hierro University Hospital, Madrid, Spain.
  • Aguado JM; Service of Infectious Diseases, Clinic University Hospital, Barcelona, Spain.
  • Arnaiz-Revillas F; Service of Clinical Microbiology and Infectious Diseases, Sanitary Research Institute, Gregorio Marañón University Hospital, Madrid, Spain.
  • Blanes-Hernández R; CIBERES (CB06/06/0058), Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain.
  • de la Torre-Cisneros J; Service of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain.
  • López-Cortés LE; Unit of Infectious Diseases, 12 de Octubre University Hospital, 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain.
  • García de Vinuesa-Calvo E; Service of Infectious Diseases, Marqués de Valdecilla University Hospital, Marqués de Valdecilla-IDIVAL, University of Cantabria, Santander, Spain.
  • Rosso CM; Section of Infectious Diseases, La Fe University Hospital, Valencia, Spain.
  • Pachón J; Service of Infectious Diseases, Reina Sofía University Hospital, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain.
  • Sánchez-Céspedes J; Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain.
  • Cordero E; Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Virgen Macarena University Hospital, Seville, Spain.
PLoS One ; 16(4): e0250796, 2021.
Article in English | MEDLINE | ID: covidwho-1207638
ABSTRACT
The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of 210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193/200 (96.5%), lopinavir/ritonavir 91/200 (45.5%), and tocilizumab 49/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant period.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / Transplant Recipients / COVID-19 / Infections Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0250796

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / Transplant Recipients / COVID-19 / Infections Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0250796