COVID-19 in kidney transplant recipients.
Am J Transplant. 2020 Apr 29;:
Authors: Nair V, Jandovitz N, Hirsch JS, Nair G, Abate M, Bhaskaran M, Grodstein E, Berlinrut I, Hirschwerk D, Cohen SL, Davidson KW, Dominello AJ, Osorio GA, Richardson S, Teperman LW, Molmenti EP
There is minimal information on COVID-19 in immunocompromised individuals. We have studied 10 patients treated at 12 adult care hospitals. Ten kidney transplant recipients tested positive for SARS-CoV-2 by PCR, and 9 were admitted. The median age was 57 (IQR 47-67), 60% were male, 40% Caucasian, and 30% Black/African American. Median time from transplant to COVID-19 testing was 2822 days (IQR 1272-4592). The most common symptom was fever, followed by cough, myalgia, chills, and fatigue. The most common CXR and CT abnormality was multifocal patchy opacities. 3 patients had no abnormal findings. Leukopenia was seen in 20% of patients, and allograft function was stable in 50% of patients. 9 patients were on tacrolimus and a mycophenolic antimetabolite, and 70% were on prednisone. Hospitalized patients had their antimetabolite agent stopped. All hospitalized patients received hydroxychloroquine (HCQ) and azithromycin. 3 patients died (30%), five (50%) developed acute kidney injury. Kidney transplant recipients infected with COVID-19 should be monitored closely in the setting of lowered immunosuppression. Most individuals required hospitalization and presenting symptoms were similar to those of non-transplant individuals.
PMID: 32351040 [PubMed - as supplied by publisher]