COVID‐19 in solid organ transplant recipients: a single‐center experience

Abstract

Summary Solid organ transplant (SOT) recipients may be at risk for severe COVID‐19. Data on the clinical course of COVID‐19 in immunosuppressed patients are limited, and the effective treatment strategy for these patients is unknown. We describe our institutional experience with COVID‐19 in SOT. Demographic, clinical, and treatment data were extracted from the electronic patient files. A total of 23 SOT transplant recipients suffering from COVID‐19 were identified (n = 3 heart; n = 15 kidney; n = 1 kidney‐after‐heart; n = 3 lung, and n = 1 liver transplant recipient). The presenting symptoms were similar to nonimmunocompromised patients. Eighty‐three percent (19/23) of the patients required hospitalization, but only two of these were transferred to the intensive care unit. Five patients died from COVID‐19; all had high Clinical Frailty Scores. In four of these patients, mechanical ventilation was deemed futile. In 57% of patients, the immunosuppressive therapy was not changed and only three patients were treated with chloroquine. Most patients recovered without experimental antiviral therapy. Modification of the immunosuppressive regimen alone could be a therapeutic option for SOT recipients suffering from moderate to severe COVID‐19. Pre‐existent frailty is associated with death from COVID‐19.

Vulnerabilities in kidney transplant recipients with COVID‐19: a single center experience

“…The latter was not significantly different between survivors and non-survivors. Our findings are in line with previous reports of the general population and solid organ transplant recipients, in which elderly and patients with comorbid conditions were at increased risk [8][9][10].…”

Frailty and COVID-19: A Systematic Scoping Review

“…Five observational studies included in this review investigated the predictive role of frailty among COVID-19 patients admitted to hospitals [ 42 , 43 , 44 , 45 , 46 ]. Baker et al simply reported that patients who died without ventilatory support were generally frail with a median Clinical Frailty Scale score of 7 (interquartile range = 6–7) [ 47 ] ( Table 1 ).…”

Suspension and resumption of kidney transplant programmes during the COVID‐19 pandemic: perspectives from patients, caregivers and potential living donors – a qualitative study

“…Many countries have restricted or suspended kidney transplantation programmes due to concerns for patient safety and the shortage of healthcare resources during the pandemic [2,[4][5][6][7][8][9]. There are some data to suggest that kidney transplant recipients are at an increased risk of severe COVID-19 because of immunosuppression and comorbid conditions [7,[10][11][12][13].…”