COVID-19 in kidney transplant recipients

Gandolfini, Ilaria; Delsante, Marco; Fiaccadori, Enrico; Zaza, Gianluigi; Manenti, Lucio; Antoni, Anna; Peruzzi, Licia; Riella, Leonardo V.; Cravedi, Paolo; Maggiore, Umberto

doi:10.1111/ajt.15891

Cited by 187 publications

(251 citation statements)

References 5 publications

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“…Encouraging results are provided by the case reported by Gandolfini et al who treated a patient with signs of systemic inflammation (plasmatic IL-6: 108.2 pg/ml; normal range 0-10 pg/ml), who received colchicine (1 mg on day 8, and 0.5 mg/day thereafter) with benefit due to worsening pf respiratory functions [215]. So far, the patients is stable, reinforcing that this is a suitable option in patients with COVID-19 disease.…”

Section: Colchicinementioning

confidence: 99%

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

Perricone

Triggianese

Bartoloni

et al. 2020

Journal of Autoimmunity

128

131

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Section: Colchicinementioning

confidence: 99%

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

Perricone

Triggianese

Bartoloni

et al. 2020

Journal of Autoimmunity

128

131

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“…[1][2][3][4][5] Given the early nature of the pandemic, knowledge about COVID-19 and its impact on solid organ transplantation (SOT) patients is limited to case reports and expert discussion. [6][7][8] There is insufficient knowledge about the natural history of COVID-19, 9,10 including lack of understanding about the potential for donor-derived infection given imperfections in currently available diagnostic tests. 2,11 There is ongoing nosocomial and community spread, 12 and more severe illness has been observed for patients with underlying conditions.…”

Section: Introductionmentioning

confidence: 99%

Early impact of COVID-19 on transplant center practices and policies in the United States

Boyarsky

Chiang

Werbel

et al. 2020

American Journal of Transplantation

228

276

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COVID-19 is a novel, rapidly changing pandemic: consequently, evidence-based recommendations in solid organ transplantation (SOT) remain challenging and unclear. To understand the impact on transplant activity across the United States, and center-level variation in testing, clinical practice, and policies, we conducted a national survey between March 24, 2020 and March 31, 2020 and linked responses to the COVID-19 incidence map. Response rate was a very high 79.3%, reflecting a strong national priority to better understand COVID-19. Complete suspension of live donor kidney transplantation was reported by 71.8% and live donor liver by 67.7%.While complete suspension of deceased donor transplantation was less frequent, some restrictions to deceased donor kidney transplantation were reported by 84.0% and deceased donor liver by 73.3%; more stringent restrictions were associated with higher regional incidence of COVID-19. Shortage of COVID-19 tests was reported by 42.5%. Respondents reported a total of 148 COVID-19 recipients from <1 to >10 years posttransplant: 69.6% were kidney recipients, and 25.0% were critically ill. Hydroxychloroquine (HCQ) was used by 78.1% of respondents; azithromycin by 46.9%; tocilizumab by 31.3%, and remdesivir by 25.0%. There is wide heterogeneity in center-level response across the United States; ongoing national data collection, expert discussion, and clinical studies are critical to informing evidence-based practices. K E Y W O R D Sclinical decision-making, epidemiology, guidelines, infectious agents-viral

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“…At the time of writing, published data are available in 11 transplant patients infected with SARS-CoV-2 (eight adult and three pediatric patients). [2][3][4][5][6] Calcineurin inhibitors (CNIs) are the cornerstone of transplant maintenance immunosuppressive regimens, and all patients were receiving CNIs at the time of diagnosis. In keeping with what is known in the general population, all pediatric outcomes were favorable.…”

mentioning

confidence: 99%

“…In the adult cases, seven of the eight case reports describe management that included withdrawal of both CNIs and antiproliferative agents; in these cases, outcomes were variable (three patients survived, three remain in critical care, and two deaths). [2][3][4]6 Several guidelines have since been developed that recommend withdrawal of CNIs in transplant patients with severe SARS-CoV-2 infection. 7,8 Two features of CNIs, one experimental and the other clinical, warrant attention because they may have important repercussions not only for patients who have received a transplant but also in the management of SARS-CoV-2 infection in general.…”

mentioning

confidence: 99%