Initial Report From a Swedish High-volume Transplant Center After the First Wave of the COVID-19 Pandemic

Abstract

The authors declare no conflicts of interest. M.F. designed the study, collected data, analyzed results, and reviewed the article. J.M.S. designed the study, collected data, analyzed results, and drafted the article. J.M. collected data, analyzed results, and revised the article. J.E. collected data, analyzed results, and revised the article. K.K. collected data, analyzed results, and drafted the article. A.S. collected data, analyzed results, and revised the article. H.L. collected data, analyzed results, and revised the article. M.O. designed the study, collected data, analyzed results, and drafted the article. V.F. designed the study, collected data, analyzed results, and drafted the article.

COVID-19 after kidney transplantation: Early outcomes and renal function following antiviral treatment

“…Although the median age of the patients appears slightly lower than in other reports, the overall patient profile in terms of comorbidities and sex distribution appears to be similar to other reports (Felldin et al, 2021;Lubetzky et al, 2020). The overall outcomes of this first Eastern European cohort of transplant patients are comparable to those of patients in other single-centre reports or registry analyses, and this further suggests the existence of yet unidentified risk factors particular to this patient group (Caillard et al, 2020;Felldin et al, 2021;Hoek et al, 2020;Hillbrands et al, 2020;Kute et al, 2020;Nair et al, 2020).…”

Impact of COVID-19 in solid organ transplant recipients

“…In solid organ transplant (SOT) recipients, the extent of immunosuppression correlates with the severity of diverse infectious diseases, 13 which led to the initial prediction that SOT recipients may be more susceptible to severe COVID‐19. Indeed, the risk of mortality in transplant recipients seems higher than in the general population 14‐17 . However, this has not been universally noted.…”

“…In recent international cohorts, 78–89% of identified patients were hospitalized which is higher than in the general public, although this also may reflect reporting or testing bias of differential health care utilization for transplant patients 17,90 . Once hospitalized, rates of transition to the intensive care unit ranged from 8.6% in the Netherlands to 18%–34% in other cohorts internationally 15,17,33,79,84,91,92 . Intubation and non‐invasive ventilation ranged broadly from 8 to 60% in smaller cohorts 78,79,83,93 ; however, the largest cohorts reported 30%–39% non‐invasive ventilation or intubation 17,84,92 .…”

“…The presentation of SOT recipients with COVID‐19 appears similar to the general population. Fever (61–83%), cough (45–75%), and diarrhea (22–57%) were the most common symptoms reported 14‐16,71,75,79,80,83‐88 . Abnormalities in chest imaging occurred frequently; cohorts of SOT recipients in New York City reported abnormal chest radiographs in 96%–100% 83,84 .…”

“…Hospitalization, morbidity, and mortality from COVID‐19 ranged broadly across populations and countries. Reported hospitalization rates ranged from 32 to 78% in most studies that included outpatients 14‐17 . However, reporting bias certainly occurred, especially in large cohorts with voluntary reporting of cases and limited testing availability early in the pandemic for non‐hospitalized patients.…”