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COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium.
Cravedi, Paolo; Mothi, Suraj S; Azzi, Yorg; Haverly, Meredith; Farouk, Samira S; Pérez-Sáez, María J; Redondo-Pachón, Maria D; Murphy, Barbara; Florman, Sander; Cyrino, Laura G; Grafals, Monica; Venkataraman, Sandheep; Cheng, Xingxing S; Wang, Aileen X; Zaza, Gianluigi; Ranghino, Andrea; Furian, Lucrezia; Manrique, Joaquin; Maggiore, Umberto; Gandolfini, Ilaria; Agrawal, Nikhil; Patel, Het; Akalin, Enver; Riella, Leonardo V.
  • Cravedi P; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Mothi SS; Schuster Transplantation Research Center, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Azzi Y; Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA.
  • Haverly M; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Farouk SS; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.
  • Pérez-Sáez MJ; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
  • Redondo-Pachón MD; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
  • Murphy B; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Florman S; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.
  • Cyrino LG; Schuster Transplantation Research Center, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Grafals M; Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
  • Venkataraman S; Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
  • Cheng XS; Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, Massachusetts, USA.
  • Wang AX; Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, Massachusetts, USA.
  • Zaza G; Renal Unit, Department of Medicine, University Hospital of Verona, Verona, Italy.
  • Ranghino A; SOD Nefrologia, Dialisi e Trapianto Rene, AOU Ospedali Riuniti, Ancona, Italy.
  • Furian L; Kidney and Pancreas Transplantation Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.
  • Manrique J; Nephrology Service, Complejo Hospitalario de Navarra, Pamplona, Spain.
  • Maggiore U; Dipartimento di Medicina e Chirurgia, Università di Parma, UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Parma, Italy.
  • Gandolfini I; Dipartimento di Medicina e Chirurgia, Università di Parma, UO Nefrologia, Azienda Ospedaliera-Universitaria Parma, Parma, Italy.
  • Agrawal N; Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
  • Patel H; Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
  • Akalin E; Division of Nephrology, Montefiore Medical Center Transplant Center, Albert Einstein College of Medicine, Bronx, New York, USA.
  • Riella LV; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Transplant ; 20(11): 3140-3148, 2020 11.
Article in English | MEDLINE | ID: covidwho-638753
ABSTRACT
Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVID-19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% were African American. Prevalent comorbidities included hypertension (95%), diabetes (52%), obesity (49%), and heart (28%) and lung (19%) disease. Therapeutic management included antimetabolite withdrawal (68%), calcineurin inhibitor withdrawal (23%), hydroxychloroquine (71%), antibiotics (74%), tocilizumab (13%), and antivirals (14%). During a median follow-up period of 52 days (IQR 16-66 days), acute kidney injury occurred in 52% cases, with respiratory failure requiring intubation in 29%, and the mortality rate was 32%. The 46 patients who died were older, had lower lymphocyte counts and estimated glomerular filtration rate levels, and had higher serum lactate dehydrogenase, procalcitonin, and interleukin-6 levels. In sum, hospitalized kidney transplant recipients with COVID-19 have higher rates of acute kidney injury and mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunosuppression Therapy / Kidney Transplantation / Pandemics / Transplant Recipients / SARS-CoV-2 / COVID-19 / Graft Rejection Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America / Europa Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2020 Document Type: Article Affiliation country: Ajt.16185

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunosuppression Therapy / Kidney Transplantation / Pandemics / Transplant Recipients / SARS-CoV-2 / COVID-19 / Graft Rejection Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America / Europa Language: English Journal: Am J Transplant Journal subject: Transplantation Year: 2020 Document Type: Article Affiliation country: Ajt.16185