Risk of COVID‐19 in young kidney transplant recipients. Results from a single‐center observational study

Angeletti, Andrea; Trivelli, Antonella; Magnasco, Alberto; Drovandi, Stefania; Sanguineri, Francesca; Santaniello, Maria Grazia; Ferrando, Giulia; Forno, Roberto; Cipresso, Gaia; Tripodi, Gino; Riella, Leonardo V.; Cravedi, Paolo; Ghiggeri, Gian Marco

doi:10.1111/ctr.13889

Cited by 12 publications

(15 citation statements)

References 1 publication

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“…Currently available evidence suggests that this population is not at increased risk of severe COVID-19 disease. 36-39…”

Section: Recommendationsmentioning

confidence: 99%

“…Currently available evidence suggests that this population is not at increased risk of severe COVID-19 disease. [36][37][38][39] Given the currently available evidence, the system must balance the benefits of transplantation and the potential loss of organs, with the risks related to resource utilization and immunosuppression. In response to this, the Canadian Blood Services and Canadian Society of Transplantation in conjunction with provincial organ procurement agencies, adult/ pediatric organ donation and transplant leaders across the country came together to develop a strategy for phased reopening of transplantation activity in a safe and rational manner.…”

Section: Rationalementioning

confidence: 99%

See 1 more Smart Citation

Management of Pediatric Kidney Transplant Patients During the COVID-19 Pandemic: Guidance From the Canadian Society of Transplantation Pediatric Group

Teoh

Gaudreault-Tremblay

Blydt-Hansen

et al. 2020

Can J Kidney Health Dis

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Purpose of the program: To provide guidance on the management of pediatric kidney transplant patients during the COVID-19 pandemic. Sources of information: Program-specific documents, preexisting, and related to COVID-19; documents from provincial, national, and international kidney transplant societies/agencies and organ procurement agencies; national and international webinars, including webinars that we hosted for input and feedback; with additional information from formal and informal review of published academic literature. Methods: Challenges in the care of pediatric kidney transplant patients during the COVID-19 pandemic were highlighted within the Canadian Society of Transplantation (CST) Pediatric Group. It identified pediatric kidney transplant nephrologists (including a pediatric nephrologist ethicist) across the country and formed a workgroup. The initial guidance document was drafted and members of the workgroup reviewed and discussed all suggestions in detail via e-mail and virtual meetings. Disagreements were resolved by consensus. The document was reviewed by the CST Kidney Transplant Working Group, by the Canadian Society of Nephrology (CSN) COVID-19 Rapid Response Team (RRT), and an infectious disease expert. The suggestions were presented at an interactive webinar sponsored by CSN in collaboration with the CST and Canadian Association of Pediatric Nephrologists (CAPN), and attended by pediatric kidney health care professionals for further peer input. Final revisions were made based on feedback received. CJKHD editors reviewed the parallel process peer review and edited the manuscript for clarity. Key findings: We identified 8 key areas of pediatric kidney transplant care that may be affected by the COVID-19 pandemic: (1) transplant activity, (2) outpatient clinic activity, (3) monitoring, (4) multidisciplinary care, (5) medications (immunosuppression and others), (6) patient/family education/support, (7) school and employment, and (8) management of pediatric kidney transplant patients who are COVID-19 positive. We make specific suggestions for each of these areas. Limitations: A full systematic review of available literature was not undertaken for the sake of expediency in development of this guideline. There is a paucity of literature to support evidence-based recommendations at this time. Instead, these guidelines were formulated based on expert opinion derived from available knowledge/experience and are subject to the biases associated with this level of evidence. The parallel review process that was created to expedite the publication of this work may not be as robust as standard arms’ length peer review processes. Implications: These recommendations are meant to serve as a guide to pediatric kidney transplant directors, clinicians, and administrators for providing the best patient care in the context of limited resources while protecting patients and health care providers wherever possible by limiting exposure to COVID-19. We recognize that recommendations may not be applicable to all provincial/local health authority practices and that they may not be delivered to all patients given the time and resource constraints affecting the individual provincial/local health jurisdiction.

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“…Currently available evidence suggests that this population is not at increased risk of severe COVID-19 disease. 36-39…”

Section: Recommendationsmentioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Management of Pediatric Kidney Transplant Patients During the COVID-19 Pandemic: Guidance From the Canadian Society of Transplantation Pediatric Group

Teoh

Gaudreault-Tremblay

Blydt-Hansen

et al. 2020

Can J Kidney Health Dis

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“…During the same period, we also prospectively followed-up 160 kidney transplant recipients, including 64 children (≤ 18 years) and 96 young adults (19–30 years) who had received a renal transplant at our center over the last 10 years and were maintained on triple immunosuppressive therapy [ 9 ]. Similarly to the previous cohort, none of the 160 transplanted patients reported clinical symptoms of COVID-19.…”

Section: Insights From Large Pediatric Databases On Nephrotic Syndrommentioning

confidence: 99%

“…Two patients (≤ 18 years) had household members who developed severe COVID-19 requiring hospitalization, but swab tests of both of our patients resulted negative for SARS-CoV-2. Immunosuppressive therapy was not modified and neither subject reported any symptoms [ 9 ].…”

Section: Insights From Large Pediatric Databases On Nephrotic Syndrommentioning

confidence: 99%

Handling immune-suppressive therapies during SARS-CoV-2 pandemic: insights from pediatric datasets

2020

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“…The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) registry showed a low absolute risk for COVID-19 in adult KTx recipients but a high attributable mortality rate of 20% [5]. On the other hand, most of the evidence suggests that young KTx recipients are not at high risk for COVID-19 [11] and most children receiving immunosuppressive therapy for kidney disease, including KTx recipients, have a mild disease course during COVID-19 [12].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Children with Chronic Dialysis and Kidney Transplantation

Canpolat

Yıldırım

Yıldız

et al. 2021

Preprint

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The aim of the study is to present incidence of COVID-19 in children with renal replacement therapy (RRT) and compare the severity and outcomes of the disease between the groups undergoing dialysis and kidney transplantation (KTx). This multicenter observational study was based on data collected from children receiving RRT, either chronic dialysis or KTx, diagnosed with COVID-19. All members of the Istanbul branch of the Turkish Pediatric Nephrology Association were requested to submit all their confirmed COVID-19 cases between April 1 and December 31, 2020. They were also asked to report the number of their prevalent patients on RRT under the age of 20. A total of 46 RRT patients diagnosed with COVID-19 were reported from 12 centers. Of these, 29 were KTx recipients, and 17 were on dialysis. COVID-19 cases represented 9.3% of all prevalent dialysis patients and 9.2% of all prevalent KTx recipients. Twelve KTx recipients (41.4%) and three dialysis patients (17.6%) were asymptomatic (p = 0.12). The hospitalization rate was higher in dialysis patients than KTx recipients (82.4% vs. 27.6%, p = 0.001). Two patients, one in each group, experienced a severe disease course, and only one hemodialysis patient had a critical illness that required mechanical ventilation. Acute kidney injury developed in 36% of KTx recipients, but none required dialysis or lost their graft. In the entire cohort, one patient on hemodialysis with multiple comorbidities died.Conclusion: Although most of cases were asymptomatic or had a mild disease, children on RRT seem to have an increased risk for COVID-19.

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Risk of COVID‐19 in young kidney transplant recipients. Results from a single‐center observational study

Cited by 12 publications

References 1 publication

Management of Pediatric Kidney Transplant Patients During the COVID-19 Pandemic: Guidance From the Canadian Society of Transplantation Pediatric Group

Management of Pediatric Kidney Transplant Patients During the COVID-19 Pandemic: Guidance From the Canadian Society of Transplantation Pediatric Group

Handling immune-suppressive therapies during SARS-CoV-2 pandemic: insights from pediatric datasets

COVID-19 in Children with Chronic Dialysis and Kidney Transplantation

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