COVID-19 in solid organ transplantation patients: A systematic review

Nacif, Lucas Souto; Zanini, Leonardo Yuri; Waisberg, Daniel Reis; Pinheiro, Rafael Soares; Galvão, Fla ́vio; Andraus, Wellington; D’Albuquerque, Luiz Carneiro

doi:10.6061/clinics/2020/e1983

Cited by 57 publications

(68 citation statements)

References 33 publications

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“…Immunosuppression undoubtedly places the patient into a high-risk group for acquiring as well as transmitting the virus [10]. Most agree that, as in our patient, the initial presentation does not differ from that in the general population [11].…”

Section: Disease Course and Treatment Of Immunocompromised Individualssupporting

confidence: 60%

A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

et al. 2020

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The evolving pandemic of Coronavirus Disease 2019 has posed a substantial health risk worldwide. However, there is a paucity of data regarding the clinical course and the therapeutic management of patients with chronic kidney disease and COVID-19 infection. To date, most evidence has come from renal transplantation, with about 45 patients reported thus far, and the current data from the ERA-EDTA (ERACODA) registry for transplanted patients and patients on Renal Replacement Therapy (RRT); as for those with glomerular diseases, data are lacking. Herein, we report the case of a 62-year-old patient with severe membranoproliferative glomerulonephritis who had been receiving a high burden of immunosuppression until four months before the COVID-19 infection. He developed severe disease with acute respiratory failure requiring mechanical ventilation. After treatment with hydroxychloroquine and azithromycin, despite his low chances, he gradually recovered and survived. To the best of our knowledge, this is one of the few reported patients with glomerulonephritis who had COVID-19 Besides our single case with glomerulonephritis early during the disease outbreak, the very low prevalence of COVID-19 infection in the country’s transplant recipients (0.038%) and dialysis patients (0.24%) reflects the impact of the rapid implementation of social distancing rules as well as of preventive measures for disease control in the hospitals and dialysis units in our country.

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Section: Disease Course and Treatment Of Immunocompromised Individualssupporting

confidence: 60%

A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

et al. 2020

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“…Since the onset of the COVID-19 pandemic, a growing body of literature has described the incidence, clinical course, and outcomes of COVID-19 in solid organ transplant recipients. 6 Understandably however, the majority of published studies represent small, single-center experiences and therefore do not provide a comprehensive overview of COVID-19 risk in these patients. Intuitively, one would expect kidney transplant (KTx) recipients are at higher risk of progression from subclinical SARS-CoV-2 infection to symptomatic COVID-19 when compared to immunocompetent individuals; however, the true rates of progression are unknown, and early CDC reports suggest that asymptomatic infection is common.…”

Section: Introductionmentioning

confidence: 99%

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Moris

Kesseli

Barbas

2020

Transplant Infectious Dis

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There is an accumulating body of literature surrounding the impact of COVID‐19 infection in solid organ transplant recipients. The aim of this review is to summarize the existing literature specifically in kidney transplant (KTx) recipients, with an emphasis on the epidemiology, clinical presentation, laboratory findings, post‐operative outcomes and therapeutic strategies currently employed. We identified thirty‐seven studies published between January 1 st 2020 to June 10 th 2020 that were included in our analysis. As is reported in the general population, there is a wide variation in COVID‐19 presentation among KTx patients, ranging from asymptomatic to life‐threatening end‐organ failure. The most common symptoms are predominantly respiratory and associated with fever. On lab evaluation, many patients present with lymphopenia and increased CRP, which are both associated with inferior outcomes. The majority of patients with severe symptoms have been managed with reduction of immunosuppression, including decreased doses of CNIs and withdrawal of MMF. Lastly, although there is no high‐level data supporting the use of immunomodulatory drugs, such as IL‐6 inhibitors, early experiences have suggested these drugs may improve outcomes in KTx patients with severe COVID‐19.

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“…2 The data on immunosuppression therapy, post-transplant status and impact of SARS-CoV-2 infection on a liver graft as well as the overall survival in liver graft recipients is largely inadequate. A similar lack of information is present regarding the treatment, drug interaction and overall outcome with solid organ transplant and corona virus disease 2019 (COVID- 19).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Liver Transplant Recipients - A Series with Successful Recovery

Choudhury¹,

Reddy²,

Venishetty³

et al. 2020

Journal of Clinical and Translational Hepatology

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The severe acute respiratory syndrome corona virus-2 (referred to as SARS CoV2) pandemic had a great impact on public life in general as well as on populations with preexisting disease and co-morbidities. Liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosuppression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/o convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anticoagulation, consideration of repurposed drugs (i.e. teicoplanin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.

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COVID-19 in solid organ transplantation patients: A systematic review

Cited by 57 publications

References 33 publications

A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

COVID-19 in Liver Transplant Recipients - A Series with Successful Recovery

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