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Outcomes of SOT Recipients With COVID-19 in Different Eras of COVID-19 Therapeutics.
Sait, Afrah S; Chiang, Teresa Po-Yu; Marr, Kieren A; Massie, Allan B; Cochran, Willa; Shah, Pali; Brennan, Daniel C; Thomas, Alvin G; Mehta Steinke, Seema; Permpalung, Nitipong; Shoham, Shmuel; Merlo, Christian; Jain, Tania; Boyarsky, Brian; Charnaya, Olga; Gurakar, Ahmet; Sharma, Kavita; Durand, Christine M; Werbel, William A; Huang, Chiung-Yu; Ostrander, Darin; Desai, Niraj; Kim, Min Young; Alasfar, Sami; Bloch, Evan M; Tobian, Aaron A R; Garonzik-Wang, Jacqueline; Segev, Dorry L; Avery, Robin K.
  • Sait AS; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Chiang TP; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Marr KA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Massie AB; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Cochran W; Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD.
  • Shah P; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Brennan DC; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Thomas AG; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Mehta Steinke S; Comprehensive Transplant Center, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Permpalung N; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Shoham S; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Merlo C; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Jain T; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Boyarsky B; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Charnaya O; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Gurakar A; Hematologic Malignancies and Bone Marrow Transplantation Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
  • Sharma K; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Durand CM; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Werbel WA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Huang CY; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Ostrander D; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Desai N; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Kim MY; Department of Statistics, University of California at San Francisco, San Francisco, CA.
  • Alasfar S; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Bloch EM; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Tobian AAR; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Garonzik-Wang J; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Segev DL; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Avery RK; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
Transplant Direct ; 8(1): e1268, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1583924
ABSTRACT

BACKGROUND:

Few reports have focused on newer coronavirus disease 2019 (COVID-19) therapies (remdesivir, dexamethasone, and convalescent plasma) in solid organ transplant recipients; concerns had been raised regarding possible adverse impact on allograft function or secondary infections.

METHODS:

We studied 77 solid organ transplant inpatients with COVID-19 during 2 therapeutic eras (Era 1 March-May 2020, 21 patients; and Era 2 June-November 2020, 56 patients) and 52 solid organ transplant outpatients.

RESULTS:

In Era 1, no patients received remdesivir or dexamethasone, and 4 of 21 (19.4%) received convalescent plasma, whereas in Era 2, remdesivir (24/56, 42.9%), dexamethasone (24/56, 42.9%), and convalescent plasma (40/56, 71.4%) were commonly used. Mortality was low across both eras, 4 of 77 (5.6%), and rejection occurred in only 2 of 77 (2.8%) inpatients; infections were similar in hypoxemic patients with or without dexamethasone. Preexisting graft dysfunction was associated with greater need for hospitalization, higher severity score, and lower survival. Acute kidney injury was present in 37.3% of inpatients; renal function improved more rapidly in patients who received remdesivir and convalescent plasma. Post-COVID-19 renal and liver function were comparable between eras, out to 90 d.

CONCLUSIONS:

Newer COVID-19 therapies did not appear to have a deleterious effect on allograft function, and infectious complications were comparable.

Full text: Available Collection: International databases Database: MEDLINE Topics: Long Covid Language: English Journal: Transplant Direct Year: 2022 Document Type: Article Affiliation country: Txd.0000000000001268

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Full text: Available Collection: International databases Database: MEDLINE Topics: Long Covid Language: English Journal: Transplant Direct Year: 2022 Document Type: Article Affiliation country: Txd.0000000000001268