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Attenuated early inflammatory response in solid organ recipients with COVID-19.
Bösch, Florian; Börner, Nikolaus; Kemmner, Stephan; Lampert, Christopher; Jacob, Sven; Koliogiannis, Dionysios; Stangl, Manfred; Michel, Sebastian; Kneidinger, Nikolaus; Schneider, Christian; Fischereder, Michael; Irlbeck, Michael; Denk, Gerald; Werner, Jens; Angele, Martin K; Guba, Markus O.
  • Bösch F; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Börner N; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Kemmner S; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Lampert C; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Jacob S; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Koliogiannis D; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Stangl M; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Michel S; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Kneidinger N; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Schneider C; Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Fischereder M; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Irlbeck M; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Denk G; Clinic of Cardiac Surgery, Ludwig Maximilian University Munich, Munich, Germany.
  • Werner J; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Angele MK; Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, LMU, Munich, Germany.
  • Guba MO; Transplantation Center Munich, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Clin Transplant ; 34(10): e14027, 2020 10.
Article in English | MEDLINE | ID: covidwho-615069
Semantic information from SemMedBD (by NLM)
1. Inflammatory Response PROCESS_OF Recipient
Subject
Inflammatory Response
Predicate
PROCESS_OF
Object
Recipient
2. COVID-19 PROCESS_OF Recipient
Subject
COVID-19
Predicate
PROCESS_OF
Object
Recipient
3. COVID-19 COEXISTS_WITH Immunocompromised Host
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Immunocompromised Host
4. Decreased Immunologic Activity [PE] PROCESS_OF Patients
Subject
Decreased Immunologic Activity [PE]
Predicate
PROCESS_OF
Object
Patients
5. Inflammatory Response AFFECTS Patients
Subject
Inflammatory Response
Predicate
AFFECTS
Object
Patients
6. Inflammatory Response PROCESS_OF Recipient
Subject
Inflammatory Response
Predicate
PROCESS_OF
Object
Recipient
7. COVID-19 PROCESS_OF Recipient
Subject
COVID-19
Predicate
PROCESS_OF
Object
Recipient
8. COVID-19 COEXISTS_WITH Immunocompromised Host
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
Immunocompromised Host
9. Decreased Immunologic Activity [PE] PROCESS_OF Patients
Subject
Decreased Immunologic Activity [PE]
Predicate
PROCESS_OF
Object
Patients
10. Inflammatory Response AFFECTS Patients
Subject
Inflammatory Response
Predicate
AFFECTS
Object
Patients
ABSTRACT
Immunosuppression leaves transplanted patients at particular risk for severe acute respiratory syndrome 2 (SARS-CoV-2) infection. The specific features of coronavirus disease 2019 (COVID-19) in immunosuppressed patients are largely unknown and therapeutic experience is lacking. Seven transplanted patients (two liver, three kidneys, one double lung, one heart) admitted to the Ludwig-Maximilians-University Munich because of COVID-19 and tested positive for SARS-CoV-2 were included. The clinical course and the clinical findings were extracted from the medical record. The two liver transplant patients and the heart transplant patient had an uncomplicated course and were discharged after 14, 18, and 12 days, respectively. Two kidney transplant recipients were intubated within 48 hours. One kidney and the lung transplant recipients were required to intubate after 10 and 15 days, respectively. Immunosuppression was adapted in five patients, but continued in all patients. Compared to non-transplanted patients at the ICU (n = 19) the inflammatory response was attenuated in transplanted patients, which was proven by decreased IL-6 blood values. This analysis might provide evidence that continuous immunosuppression is safe and probably beneficial since there was no hyperinflammation evident. Although transplanted patients might be more susceptible to an infection with SARS-CoV-2, their clinical course seems to be similar to immunocompetent patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Postoperative Complications / Organ Transplantation / Immunocompromised Host / COVID-19 / Graft Rejection / Immunosuppressive Agents / Inflammation Subject: Postoperative Complications / Organ Transplantation / Immunocompromised Host / COVID-19 / Graft Rejection / Immunosuppressive Agents / Inflammation Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Language: English Journal: Clin Transplant Clinical aspect: Etiology / Prognosis / Therapy Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Postoperative Complications / Organ Transplantation / Immunocompromised Host / COVID-19 / Graft Rejection / Immunosuppressive Agents / Inflammation Subject: Postoperative Complications / Organ Transplantation / Immunocompromised Host / COVID-19 / Graft Rejection / Immunosuppressive Agents / Inflammation Type of study: Diagnostic study / Observational study / Prognostic study / Risk factors Language: English Journal: Clin Transplant Clinical aspect: Etiology / Prognosis / Therapy Year: 2020
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