Outcomes of SOT Recipients With COVID-19 in Different Eras of COVID-19 Therapeutics.
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
14
06
2021
revised:
05
10
2021
accepted:
19
10
2021
entrez:
30
12
2021
pubmed:
31
12
2021
medline:
31
12
2021
Statut:
epublish
Résumé
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. 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. 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. Newer COVID-19 therapies did not appear to have a deleterious effect on allograft function, and infectious complications were comparable.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
Newer COVID-19 therapies did not appear to have a deleterious effect on allograft function, and infectious complications were comparable.
Identifiants
pubmed: 34966840
doi: 10.1097/TXD.0000000000001268
pmc: PMC8710330
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e1268Subventions
Organisme : NIA NIH HHS
ID : F99 AG073565
Pays : United States
Organisme : NIDDK NIH HHS
ID : K01 DK101677
Pays : United States
Organisme : NIDDK NIH HHS
ID : K23 DK115908
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK101828
Pays : United States
Informations de copyright
Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
Références
Transplantation. 2020 Nov;104(11):2225-2233
pubmed: 32804802
Transplantation. 2020 Nov;104(11):2208-2214
pubmed: 32496357
Transplantation. 2021 Jan 1;105(1):138-150
pubmed: 32941394
Transplantation. 2021 Jan 1;105(1):128-137
pubmed: 32890139
Kidney Int Rep. 2021 Jan;6(1):24-45
pubmed: 33163708
Kidney Int Rep. 2021 Jan;6(1):206-210
pubmed: 33073066
Transplant Proc. 2020 Nov;52(9):2620-2625
pubmed: 32798002
Clin Transplant. 2019 Sep;33(9):e13507
pubmed: 30793386
N Engl J Med. 2020 Nov 19;383(21):2030-2040
pubmed: 33031652
Curr Transplant Rep. 2020;7(4):366-378
pubmed: 33145146
Curr Transplant Rep. 2020;7(4):379-389
pubmed: 33110739
Clin Infect Dis. 2008 Jun 15;46(12):1813-21
pubmed: 18462102
N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
Clin Transplant. 2020 Dec;34(12):e14089
pubmed: 32918761
Clin Infect Dis. 2016 Sep 1;63(5):e61-e111
pubmed: 27418577
N Engl J Med. 2021 Mar 18;384(11):1015-1027
pubmed: 33523609
Transplantation. 2021 Jan 1;105(1):56-60
pubmed: 33141805
Clin Transplant. 2020 Nov;34(11):e14059
pubmed: 32762055
Clin Infect Dis. 2017 Jan 1;64(1):87-91
pubmed: 27682069
Biostatistics. 2009 Jan;10(1):1-2
pubmed: 18550565
Transpl Infect Dis. 2021 Feb;23(1):e13451
pubmed: 32815238
Curr Transplant Rep. 2020;7(4):355-365
pubmed: 33101837
Kidney Int. 2020 Dec;98(6):1549-1558
pubmed: 32853631
N Engl J Med. 2020 Nov 5;383(19):1813-1826
pubmed: 32445440
J Am Soc Nephrol. 2020 Jul;31(7):1384-1386
pubmed: 32513665
Am J Transplant. 2021 Jul;21(7):2498-2508
pubmed: 33284498