Impact of immunosuppression regimen on COVID-19 mortality in kidney transplant recipients: Analysis from a Colombian transplantation centers registry

Montero, Camilo; Torres, Rodolfo; Benavidez, Carlos; Padilla, Paola Karina García; Jiménez, Sandra Juliana; Yomayusa, Nancy; Gayon, Diana; Perez, Jorge; Rosselli, Diego; Restrepo, Héctor Fabio; Álvarez-Moreno, Carlos

doi:10.1016/j.nefro.2022.09.003

Cited by 3 publications

(6 citation statements)

References 45 publications

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“…Durante la pandemia el manejo inmunosupresor en este grupo poblacional fue bastante debatido; en general los grupos asistenciales tuvieron que tomar decisiones que implicaban el riesgo de rechazo del injerto o el desarrollo de un cuadro clínico por COVID-19 con mayor severidad clínica 19 . En nuestra experiencia, la necesidad de suspender completamente la inmunosupresión se relacionó con una presentación mucho más grave de la enfermedad y se asoció con el desenlace de mortalidad (p = 0,0001).…”

Section: Discussionunclassified

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano

Carreño-Barrera,

Lizarazo-Hernández,

Ortiz-Pulido

et al. 2024

RUC

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Objetivo: Los pacientes receptores de trasplante renal (TxR) tienen alta carga de comorbilidades y un riesgo aumentado de muerte por COVID-19. Nuestro objetivo es describir las manifestaciones y los desenlaces clínicos en un grupo de receptores de TxR con enfermedad por coronavirus 2019 (COVID-19) y definir factores asociados a mortalidad. Métodos: Estudio de corte transversal que incluyó la revisión retrospectiva de registros clínicos de pacientes receptores de TxR y diagnóstico de COVID-19 entre marzo de 2020 y febrero de 2022 en un centro de alta complejidad en Bogotá (Colombia). Se ejecutó un análisis bivariante y multivariante para establecer asociaciones entre las variables de interés y el desenlace en mortalidad. Resultados: Se incluyeron un total de 94 casos. El 71,28% tenía un TxR, principalmente de donante cadavérico. Las manifestaciones clínicas incluyeron la tos en el 79,7%, fiebre en el 50% y disnea en el 42,55% de los casos. La tasa de mortalidad global fue del 18,09%. En el 54,9% se realizó un ajuste inmunosupresor, con interrupción completa del esquema hasta en el 74% de estos casos. Conclusiones: La tasa de mortalidad evidenciada en receptores de TxR con COVID-19 es mayor

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Section: Discussionunclassified

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano

Carreño-Barrera,

Lizarazo-Hernández,

Ortiz-Pulido

et al. 2024

RUC

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“…Findings were consistent with those found in previous studies in a similar population. 8 Previous infection with a different variant of Omicron was associated with a reduction in the risk of infection of approximately 50%, finding greater efficacy with hybrid immunity from previous infection and recent booster vaccination (up to 80%), a finding described in a national study in Qatar 30 ; unvaccinated people with previous infection may have infection-induced immunity, which represents a bias when evaluating the effectiveness of vaccination, even presenting higher levels of protection than those vaccinated without a history of exposure. [31][32][33] In this study, previous infection with other variants was not taken into account for the analysis of adverse clinical outcomes, and it remains to be established whether protection against the Omicron variant is provided by immunity associated with previous infection, vaccination, or a combination of both.…”

Section: Discussionmentioning

confidence: 99%

“…[31][32][33] In this study, previous infection with other variants was not taken into account for the analysis of adverse clinical outcomes, and it remains to be established whether protection against the Omicron variant is provided by immunity associated with previous infection, vaccination, or a combination of both. Hospitalization rates in recipients of solid organ transplants during the predominance of the Omicron variant have been reported in up to 26% of confirmed cases 34 ; an analysis carried out in seven transplant centers in the city of Bogota, Colombia, found a case fatality rate of 17% and a hospitalization rate of 49.7% in renal transplant recipients with SARS-CoV-2 infection in the pre-vaccination era, 8 which is in contrast to a case fatality rate of 9.3% and a hospitalization rate of 23.26% found in this study, suggesting that vaccination is associated with a lower risk of hospitalization and death in solid organ transplant recipients as has been reported in heart transplant recipients with SARS-CoV-2 infection. 35 This protective effect of vaccination independent of antibody titers has been demonstrated in the transplant population in other types of vaccination strategies such as influenza, suggesting that not only humoral but also cellular immunity is involved in the protective effect of vaccination in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…In seven transplant centers in Bogota, Colombia, a 17% mortality of renal transplant recipients with SARS-CoV-2 infection prior to the start of vaccination schedules was found. 8…”

Section: Introductionmentioning

confidence: 99%

“…6,7 In seven transplant centers in Bogota, Colombia, a 17% mortality of renal transplant recipients with SARS-CoV-2 infection prior to the start of vaccination schedules was found. 8 The different vaccination platforms generate a lower humoral response in solid organ transplant recipients in comparison with the general population [1][2][3][4] , which may be related to immunosuppression. 9 Under a mRNA platform in general, a response close to 50% has been found after two doses of vaccination 10 .…”

Section: Introductionmentioning

confidence: 99%

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Response of antibody titers to SARS-CoV-2 vaccination and clinical outcomes during the predominance of the Omicron variant in Colombia

et al. 2023

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Introduction: The response to vaccination against the virus that causes severe acute respiratory infection syndrome coronavirus 2 is lower in renal transplant recipients than in the general population. The data obtained from Latin America showed reduced immunogenicity under inactivated virus vaccination schedules and messenger ribonucleic acid platforms. Methods: A retrospective cohort study including renal transplant recipients from Colombia with a two-dose vaccination schedule against severe acute respiratory infection syndrome coronavirus 2 with Pfizer, AstraZeneca, Moderna, Jansen, and Sinovac vaccines between March 1, 2021 and December 1, 2021, was carried out with a follow-up period to evaluate outcomes until May 2022. The outcomes correspond to the titers of immunoglobulin G antibodies against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike and a composite outcome of mortality, general, and intensive care unit hospitalization. Results: In total, 215 renal transplant recipients with two doses of vaccination for severe acute respiratory infection syndrome coronavirus 2 during the predominance of the Omicron variant in Colombia were included, with the measurement of immunoglobulin G antibody titers against the receptor binding domain of the severe acute respiratory infection syndrome coronavirus 2 spike at 8 weeks of vaccination. The mean age was 52.1 years, and the standard deviation was ± 14.2; severe acute respiratory infection syndrome coronavirus 2 infection occurred in 20% of the population, of which 23.26% required hospitalization, 13.95% were under intensive care unit management, and four cases of mortality (9.3%) were reported. Of the total population, 52.5% had antibody titers higher than 0.8 IU/mL (median 0.77 IU/mL, interquartile range 0.4–131). Patients with severe acute respiratory infection syndrome coronavirus 2 infection had a median antibody titer of 0.4 IU/mL (interquartile range 0.4–3.45), and those without infection had a median antibody titer of 1.8 IU/mL (interquartile range 0.4–202) ( p = 0.015). Conclusion: Anti-severe acute respiratory infection syndrome coronavirus 2 antibody titers with a cutoff point less than 0.8 IU/mL are associated with increased risk of severe acute respiratory infection syndrome coronavirus 2 infection.

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The neurophysiological basis of stress and anxiety - comparing neuronal diversity in the bed nucleus of the stria terminalis (BNST) across species

van de Poll,

Cras,

Ellender

2023

Front. Cell. Neurosci.

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The bed nucleus of the stria terminalis (BNST), as part of the extended amygdala, has become a region of increasing interest regarding its role in numerous human stress-related psychiatric diseases, including post-traumatic stress disorder and generalized anxiety disorder amongst others. The BNST is a sexually dimorphic and highly complex structure as already evident by its anatomy consisting of 11 to 18 distinct sub-nuclei in rodents. Located in the ventral forebrain, the BNST is anatomically and functionally connected to many other limbic structures, including the amygdala, hypothalamic nuclei, basal ganglia, and hippocampus. Given this extensive connectivity, the BNST is thought to play a central and critical role in the integration of information on hedonic-valence, mood, arousal states, processing emotional information, and in general shape motivated and stress/anxiety-related behavior. Regarding its role in regulating stress and anxiety behavior the anterolateral group of the BNST (BNSTALG) has been extensively studied and contains a wide variety of neurons that differ in their electrophysiological properties, morphology, spatial organization, neuropeptidergic content and input and output synaptic organization which shape their activity and function. In addition to this great diversity, further species-specific differences are evident on multiple levels. For example, classic studies performed in adult rat brain identified three distinct neuron types (Type I-III) based on their electrophysiological properties and ion channel expression. Whilst similar neurons have been identified in other animal species, such as mice and non-human primates such as macaques, cross-species comparisons have revealed intriguing differences such as their comparative prevalence in the BNSTALG as well as their electrophysiological and morphological properties, amongst other differences. Given this tremendous complexity on multiple levels, the comprehensive elucidation of the BNSTALG circuitry and its role in regulating stress/anxiety-related behavior is a major challenge. In the present Review we bring together and highlight the key differences in BNSTALG structure, functional connectivity, the electrophysiological and morphological properties, and neuropeptidergic profiles of BNSTALG neurons between species with the aim to facilitate future studies of this important nucleus in relation to human disease.

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Impact of immunosuppression regimen on COVID-19 mortality in kidney transplant recipients: Analysis from a Colombian transplantation centers registry

Cited by 3 publications

References 45 publications

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano

Response of antibody titers to SARS-CoV-2 vaccination and clinical outcomes during the predominance of the Omicron variant in Colombia

The neurophysiological basis of stress and anxiety - comparing neuronal diversity in the bed nucleus of the stria terminalis (BNST) across species

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