Sunday, July 12, 2020

Kidney Transplant Recipients Hard Hit by COVID-19, Study Finds

Transplant News Sharing // News from Source www.renalandurologynews.com

Kidney transplant recipients appear to be at high risk for moderate to severe COVID-19 due to immunosuppressive medications and pre-existing conditions, according to Enver Akalin, MD, and colleagues from Montefiore Medical Center in the Bronx, New York.

At their center, 36 kidney transplant recipients (75% transplanted with a deceased donor kidney; 72% male; median age 60 years; 42% Hispanic; 39% black) tested positive for COVID-19 from March 16 to April 1, 2020. Overall, 94% had hypertension, 69% had diabetes mellitus, and 17% had heart disease — conditions associated with more severe COVID-19 infection. A third of patients had smoking history.

Fewer transplant recipients than expected initially presented with fever (58%) and 22% had diarrhea. Immune cell counts were lower in the transplant recipients than in the general population with COVID-19, and their condition deteriorated more rapidly; inflammation was rampant. Of the 36 patients, 28 (78%) of the transplant recipients were admitted to Montefiore’s hospital, where chest radiographs revealed viral pneumonia in 27 (96%) and 11 (39%) required mechanical ventilation. Six patients (21%) received renal replacement therapy for acute kidney injury.

For immunosuppression, 35 patients (97%)
had been receiving tacrolimus, 34 (94%) prednisone, and 31 (86%) mycophenolate
mofetil or mycophenolic acid. Montefiore clinicians withdrew an antimetabolite from
24 (86%) of the hospitalized patients and tacrolimus from 6 (21%).

For COVID-19 treatment, 24 patients (86%)
received investigational hydroxychloroquine. Six patients (21%) received the
CCR5 inhibitor leronlimab (PRO 140, CytoDyn) on a compassionate-use basis, and
2 (7%) received the interleukin-6 receptor antagonist tocilizumab. Nearly half
of patients received the antibiotic azithromycin. Patients with d-dimer levels
higher than 3.0 μg/mL received the anticoagulant apixaban.

Of the 36 patients, 10 (28%) died. Among 11 intubated patients, 7 (64%) died. Patients who died at home had recently received T-cell-depleting antithymocyte globulin. Ten hospitalized patients were eventually discharged.

“Our results show a very high early
mortality among kidney-transplant recipients with Covid-19 — 28% at 3 weeks as
compared with the reported 1% to 5% mortality among patients with Covid-19 in
the general population who have undergone testing in the United States and the
reported 8 to 15% mortality among patients with Covid-19 who are older than 70
years of age,” Dr Akalin and his colleagues stated.

Reference

Akalin E, Azzi Y, Bartash R, et al. Covid-19 and kidney transplantation [April 24, 2020]. N Engl J Med. doi: 10.1056/NEJMc2011117

Transplant News Sharing // “Kidney Transplants” – Google News from Source www.renalandurologynews.com

Transplant News
Transplant Newshttp://TransplantNews.com
Transplant News brings you original and carefully curated aggregate news stories, articles and content that matter to the transplant community, from top publishers around the web. Everything from patient stories, to the latest in transplant innovation, TN is your window into the world of transplantation.

Facebook Comments

238FansLike
27FollowersFollow
2SubscribersSubscribe

Must Read

Is tandem transplant appropriate for patients with high-risk neuroblastoma?

Transplant News Sharing // News from Source www.healio.com ...

A Stem Cell Transplant Has Cured Two HIV Patients – Now. Powered by Northrop Grumman

Transplant News Sharing // News from Source now.northropgrumman.com Human immunodeficiency virus (HIV) has been traced as far back as a century ago, but it wasn’t...

Young mother in “desperate” need of kidney transplant

Transplant News Sharing // News from Source www.wsaw.com WAUSAU, Wis. (WSAW) - There are nearly 114,000 people on the national waiting list for organ transplants...

Wakefield bride-to-be born suffering from cancer needs second life-saving liver transplant before marrying fiance

Transplant News Sharing // News from Source www.pontefractandcastlefordexpress.co.uk Rebecca Gough and James Towse.Rebecca Gough - who said she needs a full transplant within 12-months...

Not just COVID-19, shortness of breath could be a symptom of heart failure

Transplant News Sharing // News from Source www.timesnownews.com ...

Categories