COVID-19 in transplant recipients: The Spanish experience
Por:
Coll, E, Fernandez-Ruiz, M, Sanchez-Alvarez, JE, Martinez-Fernandez, JR, Crespo, M, Gayoso, J, Bada-Bosch, T, Oppenheimer, F, Moreso, F, Lopez-Oliva, MO, Melilli, E, Rodriguez-Ferrero, ML, Bravo, C, Burgos, E, Facundo, C, Lorenzo, I, Yanez, I, Galeano, C, Roca, A, Cabello, M, Gomez-Bueno, M, Garcia-Cosio, MD, Graus, J, Llado, L, de Pablo, A, Loinaz, C, Aguado, B, Hernandez, D, Dominguez-Gil, B
Publicada:
1 may 2021
Ahead of Print:
1 nov 2020
Resumen:
We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-beta (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).
Filiaciones:
Coll, E:
Spanish Natl Transplant Org, Org Nacl Trasplantes, Madrid, Spain
Fdn Puigvert, Kidney Transplant Unit, Barcelona, Spain
Fernandez-Ruiz, M:
Hosp Univ 12 Octubre, Grp Study Infect Transplantat & Immunocompromised, Spanish Soc Infect Dis & Clin Microbiol SEIMC, Unit Infect Dis,Inst Invest Sanitaria,imas12, Madrid, Spain
Spanish Soc Infect Dis & Clin Microbiol SEIMC, Grp Study Infect Transplantat & Immunocompromi, Madrid, Spain
Sanchez-Alvarez, JE:
Hosp Univ Cabuenes, Dept Nephrol, Gijon, Spain
Spanish Soc Nephrol SEN, Gijon, Spain
Martinez-Fernandez, JR:
Spanish Natl Transplant Org, Org Nacl Trasplantes, Madrid, Spain
Crespo, M:
Hosp del Mar, Dept Nephrol, Barcelona, Spain
Spanish Soc Nephrol SEN, Transplant Working Grp, Barcelona, Spain
REDinREN RD16 0009 0013, Barcelona, Spain
Gayoso, J:
Spanish Natl Transplant Org, Org Nacl Trasplantes, Madrid, Spain
Bada-Bosch, T:
Hosp Univ 12 Octubre, Dept Nephrol, Madrid, Spain
Oppenheimer, F:
Hosp Clin Barcelona, Dept Nephrol, Barcelona, Spain
Moreso, F:
Hosp Univ Vall dHebron, Dept Nephrol, Kidney Transplant Unit, Barcelona, Spain
Lopez-Oliva, MO:
Hosp Univ La Paz, Dept Nephrol, Madrid, Spain
Melilli, E:
Hosp Univ Bellvitge, Dept Nephrol, Kidney Transplant Unit, Barcelona, Spain
Rodriguez-Ferrero, ML:
Hosp Gen Univ Gregorio Maranon, Dept Nephrol, Madrid, Spain
Bravo, C:
Hosp Univ Vall dHebron, Lung Transplant Unit, Dept Pulmonol, Barcelona, Spain
Burgos, E:
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Badalona, Spain
Facundo, C:
Fdn Puigvert, Kidney Transplant Unit, Barcelona, Spain
Lorenzo, I:
Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain
Yanez, I:
Hosp Univ Cruces, Dept Nephrol, Baracaldo, Spain
Galeano, C:
Hosp Univ Ramon y Cajal, Kidney Transplant Unit, Madrid, Spain
Roca, A:
Complejo Hosp Univ Toledo, Dept Nephrol, Toledo, Spain
Cabello, M:
Hosp Reg Univ Malaga, Dept Nephrol, Malaga, Spain
Gomez-Bueno, M:
Hosp Univ Puerta Hierro, Dept Cardiol, Madrid, Spain
Garcia-Cosio, MD:
Hosp Univ 12 Octubre, Inst Invest Sanitaria, Hosp 12 Octubre, Cardiol Serv,imas12, Madrid, Spain
Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain
Graus, J:
Hosp Univ Ramon y Cajal, Dept Gastroenterol, Madrid, Spain
Llado, L:
Hosp Univ Bellvitge, Liver Transplant Unit, Barcelona, Spain
de Pablo, A:
Hosp Univ 12 Octubre, Dept Pneumol, Lung Transplant Unit, Madrid, Spain
Loinaz, C:
Hosp Univ 12 Octubre, Dept Gen Surg Digest Tract & Abdominal Organ Tran, Transplant Unit, Madrid, Spain
Aguado, B:
Hosp Univ La Princesa, Transplant Unit, Dept Hematol, Madrid, Spain
Hernandez, D:
Hosp Reg Univ, Dept Nephrol, Malaga, Spain
Inst Invest Biomed Malaga IBIMA, Malaga, Spain
Spanish Soc Transplantat SET, Malaga, Spain
Dominguez-Gil, B:
Spanish Natl Transplant Org, Org Nacl Trasplantes, Madrid, Spain
Green Accepted, Bronze
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