The Second Wave of COVID-19 Disease in a Kidney Transplant Recipient Cohort: A Single-center Experience in Belgium

Georgery, Hélène; Devresse, Arnaud; Scohy, Anaïs; Kabamba, Benoît; Darius, Tom; Buemi, Antoine; Greef, Julien De; Belkhir, Leïla; Yombi, Jean‐Cyr; Goffin, Éric; Kanaan, Nada

doi:10.1097/tp.0000000000003596

Cited by 10 publications

(13 citation statements)

References 3 publications

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“…Although the difference in mortality between the 2 waves did not reach statistical significance, the absolute numbers are strikingly similar to those of a larger Spanish cohort reporting 27 and 15% mortality during the first and second COVID waves, respectively [ 11 ]. This is in contrast with a smaller Belgian study, which found a similar mortality during the first 2 COVID waves [ 10 ]. During the first wave, Spain had disproportionately high prevalence, death toll, and mortality [ 29 ], whereas Romania and other East-European countries enforced a very strict lockdown and witnessed a limited outbreak.…”

Section: Discussioncontrasting

confidence: 99%

“…The improved testing capacity and the increased knowledge about the pathology and treatment of COVID-19 but also the emergence of mutant virus strains may have been responsible for the different patterns increasingly reported in various settings. The limited data comparing the first and second waves of the COVID-19 in kidney transplant recipients (KTx) reveal diverging results between countries and have several significant limitations such as few patients or a selection bias toward hospitalized cases [ 10 , 11 ]. We hereby present a comparison between the first and second waves of the COVID-19 pandemic at an East-European kidney transplant center, after the remission of the second wave.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the First and Second Wave of COVID-19 in Kidney Transplant Recipients: An East-European Perspective

Elec¹,

Bolboacă²,

Muntean³

et al. 2021

Eur Surg Res

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Background: The present study examined whether patient characteristics, management, and outcome of kidney transplant recipients (KTx) with COVID-19 changed in the second versus the first pandemic wave. Methods: We reviewed all available data (demographics, medical history, comorbidities, therapeutic interventions, and outcome) on our KTx with COVID-19 during the first wave (March–September 2020, n = 33) and the second wave (October 2020–February 2021, n = 149) of the COVID-19 pandemic. Results: One hundred eighty-two out of our 1,503 KTx in active follow-up got COVID-19 during 12-month period, corresponding to a prevalence of 12.1%. No difference was found in age, gender distribution, comorbidities, body mass index, or baseline immunosuppression between the 2 COVID-19 waves. Bilateral COVID pneumonia was more frequent during the first wave. More KTx were managed as outpatients during the second wave (15 vs. 39%, p < 0.01). Calcineurin inhibitors were more sparingly reduced during the second wave, whereas antimetabolites were similarly reduced (91 vs. 86, p = ns). Admission to intensive care units was comparable between the first (27%) and second waves (23%). During the first wave, 8 out of 9 patients (89%) requiring intensive care died, whereas the mortality of the ICU patients in the second wave was 68% (23 deaths) (p = 0.2). The overall mortality was 24% during the first wave and 16% during the second wave (p = 0.21), while in-hospital mortality was identical between the COVID-19 waves (27%). Increasing age and poor allograft function were significant predictors of mortality. Conclusions: Most patient characteristics and outcome were comparable between the first 2 COVID-19 waves. More KTx were managed as outpatients without an overall negative impact on outcome.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing the First and Second Wave of COVID-19 in Kidney Transplant Recipients: An East-European Perspective

Elec¹,

Bolboacă²,

Muntean³

et al. 2021

Eur Surg Res

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“…Dexamethasone was commonly used during the second wave in India, while hydroxychloroquine was more frequently applied during the first wave. 19 The analysis of the Spanish Registry (n = 1011) reported advanced age, a recent kidney transplant, and pneumonia as predictors of mortality, whereas gastrointestinal symptoms were protective. KTRs were significantly younger, had less pneumonia and received less frequently anti‐COVID‐19 treatment in the second wave, and the overall mortality was lower but similar in critical patients.…”

Section: Discussionmentioning

confidence: 99%

“… 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Likewise, data comparing the characteristics of the infection in kidney transplant recipients (KTR) between two COVID‐19 waves are scarce. 19 , 20 , 21 There are reports on the effects of the first wave on KTR in India; 22 , 23 , 24 , 25 however, there are no data currently available on the effects of the second wave from India.…”

Section: Introductionmentioning

confidence: 99%

Consequences of the first and secondCOVID‐19 wave on kidney transplant recipients at a large Indian transplant centre

et al. 2021

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Background There is a scarcity of data comparing the consequences of first and second COVID‐19 waves on kidney transplant recipients (KTRs) in India. Methods We conducted a single‐centre retrospective study of 259 KTRs with COVID‐19 to compare first wave (March 15–December 31 2020, n = 157) and second wave (April 1–May 31 2021, n = 102). Results KTRs during second wave were younger (43 vs. 40 years; p ‐value .04) and also included paediatric patients (0 vs. 5.9%; p ‐value .003). Symptoms were milder during the second wave (45 vs. 62.7%; p ‐value .007); COVID‐19 positive patients had less frequent cough (32 vs. 13.8%; p ‐value .001), fever was less frequent (58 vs. 37%; p ‐value .001), and we observed fewer co‐morbidities (11 vs. 20.6%; p ‐value .04). The percentages of neutrophils (77 vs. 83%; p ‐value .001) and serum ferritin (439 vs. 688; p ‐value .0006) were higher during second wave, while lymphocyte counts were reduced (20 vs. 14%; p ‐value .0001). Hydroxychloroquine (11 vs. 0%; p ‐value .0001) and tocilizumab (7 vs. 0%; p ‐value .004) were more frequently prescribed during first wave, while utilization of dexamethasone (6 vs. 27%; p ‐value .0001) and remdesivir (47 vs. 65%; p ‐value .03) increased during the second wave. Mucormycosis (1.3 vs. 10%; p ‐value .01) and ICU admissions (20 vs. 37.2%; p ‐value .002) were more frequent during second wave. The 28‐day mortality rate (9.6 vs. 10%; p ‐value 1) was not different. Conclusions There has been a different clinical spectrum of COVID‐19 amongst KTR with similar mortality between the two waves at a large Indian transplant centre.

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“…We also found lower figures for poor outcomes (ICU admission, death) than that reported in previous studies. In comparison with previous studies, we have also included patients diagnosed during the second and third waves of pandemic in our country and this could explain the better prognosis of the infection in our patients, considering the worse outcome of COVID-19 reported in those who were hospitalized during the first wave of pandemic in comparison with subsequent waves [30,31].…”

Section: Discussionmentioning

confidence: 99%

Characterization and Outcomes of SARS-CoV-2 Infection in Patients with Sarcoidosis

Brito-Zerón¹,

Gracia-Tello

Robles

et al. 2021

Viruses

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To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04–1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas.

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The Second Wave of COVID-19 Disease in a Kidney Transplant Recipient Cohort: A Single-center Experience in Belgium

Cited by 10 publications

References 3 publications

Comparing the First and Second Wave of COVID-19 in Kidney Transplant Recipients: An East-European Perspective

Comparing the First and Second Wave of COVID-19 in Kidney Transplant Recipients: An East-European Perspective

Consequences of the first and secondCOVID‐19 wave on kidney transplant recipients at a large Indian transplant centre

Characterization and Outcomes of SARS-CoV-2 Infection in Patients with Sarcoidosis

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