tetano
Editor, Senior Moderator
Eur Urol. 2020 Apr 18. pii: S0302-2838(20)30214-1. doi: 10.1016/j.eururo.2020.03.039. [Epub ahead of print]
Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China.
Zhu L[SUP]1[/SUP], Gong N[SUP]1[/SUP], Liu B[SUP]1[/SUP], Lu X[SUP]1[/SUP], Chen D[SUP]1[/SUP], Chen S[SUP]1[/SUP], Shu H[SUP]2[/SUP], Ma K[SUP]3[/SUP], Xu X[SUP]4[/SUP], Guo Z[SUP]5[/SUP], Lu E[SUP]6[/SUP], Chen D[SUP]7[/SUP], Ge Q[SUP]8[/SUP], Cai J[SUP]9[/SUP], Jiang J[SUP]1[/SUP], Wei L[SUP]1[/SUP], Zhang W[SUP]1[/SUP], Chen G[SUP]10[/SUP], Chen Z[SUP]11[/SUP].
Author information
Abstract
BACKGROUND:
Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations.
OBJECTIVE:
To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
DESIGN, SETTING, AND PARTICIPANTS:
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
INTERVENTION:
Immunosuppressant reduction and low-dose methylprednisolone therapy.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
RESULTS AND LIMITATIONS:
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ? 9.3 vs 12.2 ? 4.6 d in the control group) and a longer course of illness (35.3 ? 8.3 vs 18.8 ? 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
CONCLUSIONS:
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
PATIENT SUMMARY:
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Copyright ? 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
Coronavirus disease 2019; Immunosuppression; Kidney transplantation; Outcome; Pneumonia
PMID:32317180DOI:10.1016/j.eururo.2020.03.039
Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China.
Zhu L[SUP]1[/SUP], Gong N[SUP]1[/SUP], Liu B[SUP]1[/SUP], Lu X[SUP]1[/SUP], Chen D[SUP]1[/SUP], Chen S[SUP]1[/SUP], Shu H[SUP]2[/SUP], Ma K[SUP]3[/SUP], Xu X[SUP]4[/SUP], Guo Z[SUP]5[/SUP], Lu E[SUP]6[/SUP], Chen D[SUP]7[/SUP], Ge Q[SUP]8[/SUP], Cai J[SUP]9[/SUP], Jiang J[SUP]1[/SUP], Wei L[SUP]1[/SUP], Zhang W[SUP]1[/SUP], Chen G[SUP]10[/SUP], Chen Z[SUP]11[/SUP].
Author information
Abstract
BACKGROUND:
Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations.
OBJECTIVE:
To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients.
DESIGN, SETTING, AND PARTICIPANTS:
A total of 10 renal transplant recipients with laboratory-confirmed COVID-19 pneumonia were enrolled in this retrospective study. In addition, 10 of their family members diagnosed with COVID-19 pneumonia were included in the control group.
INTERVENTION:
Immunosuppressant reduction and low-dose methylprednisolone therapy.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:
The clinical outcomes (the severity of pneumonia, recovery rate, time of virus shedding, and length of illness) were compared with the control group by statistical analysis.
RESULTS AND LIMITATIONS:
The clinical symptomatic, laboratory, and radiological characteristics of COVID-19 pneumonia in the renal transplant recipients were similar to those of severe COVID-19 pneumonia in the general population. The severity of COVID-19 pneumonia was greater in the transplant recipients than in the control group (five severe/three critical cases vs one severe case). Five patients developed transient renal allograft damage. After a longer time of virus shedding (28.4 ? 9.3 vs 12.2 ? 4.6 d in the control group) and a longer course of illness (35.3 ? 8.3 vs 18.8 ? 10.5 d in the control group), nine of the 10 transplant patients recovered successfully after treatment. One patient developed acute renal graft failure and died of progressive respiratory failure.
CONCLUSIONS:
Kidney transplant recipients had more severe COVID-19 pneumonia than the general population, but most of them recovered after a prolonged clinical course and virus shedding. Findings from this small group of cases may have important implications for the treatment of COVID-19 pneumonia in immunosuppressed populations.
PATIENT SUMMARY:
Immunosuppressed transplant recipients with coronavirus disease 2019 infection had more severe pneumonia, but most of them still achieved a good prognosis after appropriate treatment.
Copyright ? 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
Coronavirus disease 2019; Immunosuppression; Kidney transplantation; Outcome; Pneumonia
PMID:32317180DOI:10.1016/j.eururo.2020.03.039