Yıl: 2021 Cilt: 51 Sayı: 2 Sayfa Aralığı: 428 - 434 Metin Dili: İngilizce DOI: 10.3906/sag-2007-260 İndeks Tarihi: 20-01-2022

Clinical course of COVID-19 disease in immunosuppressed renal transplant patients

Öz:
Background/aim: We aimed to identify clinical settings of renal transplant patients with COVID-19. Materials and methods: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. Results: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients.Conclusion: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.Key words: COVID-19, SARS-CoV-2, kidney transplantation, immunosuppression, mortality, acute rejection
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
0
0
0
  • 1. Jing Y, Ya Z, Xi G, Ke P, Zhaofeng C et al. Prevalence of comorbidities and its effects in patients infected with SARSCoV-2: a systematic review and meta-analysis. International Journal of Infectious Diseases 2020; 94: 91-95. doi: 10.1016/j. ijid.2020.03.017
  • 2. Zhang H, Chen Y, Yuan Q, Xia Q-X, Zeng X-P et al. Identification of kidney transplant recipients with Coronavirus disease 2019. European Urology 2020; 77: 742-747. doi: 10.1016/j.eururo.2020.03.030
  • 3. Guillen E, Pineiro GJ, Revuelta I, Rodriguez D, Bodro M et al. Case report of COVID‐19 in a kidney transplant recipient: does immunosuppression alter the clinical presentation? American Journal of Transplantation 2020; 20: 1875-1878. doi: 10.1111/ ajt.15874
  • 4. Fernández‐Ruiz M, Andrés A, Loinaz C, Delgado JF, López‐ Medrano F et al. COVID‐19 in solid organ transplant recipients: a single‐center case series from Spain. American Journal of Transplantation 2020; 20: 1849-1858. doi: 10.1111/ ajt.15929
  • 5. Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M et al. Covid-19 and kidney transplantation. New England Journal of Medicine 2020; 382: 2475-2477. doi: 10.1056/NEJMc2011117
  • 6. Boyarsky BJ, Chiang TP, Werbel WA, Durand CM, Avery RK et al. Early impact of COVID‐19 on transplant center practices and policies in the United States. American Journal of Transplantation 2020; 20: 1809-1818. doi: 10.1111/ajt.15915
  • 7. Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F et al. Management of patients on dialysis and with kidney transplantation during the SARS-CoV-2 (COVID-19) pandemic in Brescia, Italy. Kidney International Reports 2020; 5: 580-585. doi: 10.1016/j.ekir.2020.04.001
  • 8. Willicombe M, Thomas D, McAdoo S. COVID-19 and calcineurin inhibitors: should they get left out in the storm?. Journal of the American Society of Nephrology 2020; 31: 1145- 1146. doi: 10.1681/ASN.2020030348
  • 9. Shetty R, Ghosh A, Honavar SG, Khamar P, Sethu S. Therapeutic opportunities to manage COVID-19/SARS-CoV-2 infection: present and future. Indian Journal of Ophthalmology 2020; 68: 693-702. doi: 10.4103/ijo.IJO_639_20
  • 10. Geleris J, Sun Y, Platt J, Zucker J, Baldwin M et al. Observational study of hydroxychloroquine in hospitalized patients with Covid-19. New England Journal of Medicine 2020; 382: 2411- 2418. doi: 10.1056/NEJMoa2012410
  • 11. Peter H, Wei S L, Jonathan R E, Marion M, Jennifer L B et al. Dexamethasone in hospitalized patients with Covid-19 - preliminary report. New England Journal of Medicine 2020; 384: 693-704. doi: 10.1056/NEJMoa2021436
  • 12. Yeming W, Dingyu Z, Guanhua D, Ronghui D, Jianping Z et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020; 395 (10236): 1569-1578. doi: 10.1016/S0140- 6736(20)31022-9
  • 13. Akers WS, Flynn JD, Davis GA, Green AE, Shane Winstead P. Prolonged cardiac repolarization after tacrolimus and haloperidol administration in the critically ill patient. Pharmacotherapy 2004; 24: 404-408. doi: 10.1592/ phco.24.4.404.33172
  • 14. Fahad A, Brenda M, Sandesh P, Neetika G, Maha M et al. Unusually high rates of acute rejection during the COVID-19 pandemic: cause for concern?. Kidney International 2020; 98 (2): 513-514. doi: 10.1016/j.kint.2020.05.038
  • 15. Joshua G, Yifei S, Jonathan P, Jason Z, Matthew B et al. Observational study of hydroxychloroquine in hospitalized patients with Covid-19. New England Journal of Medicine 2020; 382 (25): 2411- 2418. doi: 10.1056/NEJMoa2012410
  • 16. Sissoko D, Laouenan C, Folkesson E, M’Lebing AB, Beavogui AH et al. Experimental treatment with favipiravir for Ebola virus disease (the JIKI trial): a historically controlled, single-arm proof-of-concept trial in Guinea. PLoS Medicine 2016; 13 (3): e1001967. doi: 10.1371/journal.pmed.1001967
  • 17. Cai Q, Yang M, Liu D, Chen J, Shu D et al. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering (Beijing) 2020; 6 (10): 1192-1198 doi: 10.1016/j. eng.2020.03.007
  • 18. Zhu L, Gong N, Liu B, Lu X, Chen D et al. Coronavirus disease 2019 pneumonia in immunosuppressed renal transplant recipients: a summary of 10 confirmed cases in Wuhan, China. European Urology 2020; 77: 748-754. doi: 10.1016/j. eururo.2020.03.039
  • 19. Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney International 2020; 97: 1083-1088. doi: 10.1016/j.kint.2020.04.002
  • 20. Banerjee D, Popoola J, Shah S, Ster IC, Quan V et al. COVID-19 infection in kidney transplant recipients. Kidney International 2020; 97: 1076-1082. doi: 10.1016/j.kint.2020.03.018
  • 21. Paolo C, Sarvode MS, Yorg A, Meredith H, Samira F et al. COVID-19 and kidney transplantation: results from the TANGO International Transplant Consortium. Journal of the American Society of Nephrology 2020; 20 (11): 3140-3148. doi: 10.1111/ajt.16185
  • 22. Zhou F, Yu T, Du R, Fan G, Liu Y et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395 (10229): 1054-1062. doi: 10.1016/S0140-6736(20)30566-3
  • 23. Liliana S, France G, Devendra KA, Patrick SL, Jacques L. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clinical Infectious Diseases 2004; 39 (2): 206-217. doi: 10.1086/421997
  • 24. Fang L, Lin L, MengDa X, Juan W, Ding L et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. Journal of Clinical Virology 2020; 127: 104370. doi: 10.1016/j.jcv.2020.104370
APA dheir h, SİPAHİ S, YAYLACI S, ÇETİN E, Genc A, Firat N, Koroglu M, Muratdağı G, tomak y, ÖZMEN SÜNER K, Ateş Ö, KARABAY O (2021). Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. , 428 - 434. 10.3906/sag-2007-260
Chicago dheir hamad,SİPAHİ Savaş,YAYLACI SELÇUK,ÇETİN Esma Seda,Genc Ahmed Bilal,Firat Necattin,Koroglu Mehmet,Muratdağı Gürkan,tomak yakup,ÖZMEN SÜNER KEZBAN,Ateş Ömer Faruk,KARABAY OĞUZ Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. (2021): 428 - 434. 10.3906/sag-2007-260
MLA dheir hamad,SİPAHİ Savaş,YAYLACI SELÇUK,ÇETİN Esma Seda,Genc Ahmed Bilal,Firat Necattin,Koroglu Mehmet,Muratdağı Gürkan,tomak yakup,ÖZMEN SÜNER KEZBAN,Ateş Ömer Faruk,KARABAY OĞUZ Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. , 2021, ss.428 - 434. 10.3906/sag-2007-260
AMA dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. . 2021; 428 - 434. 10.3906/sag-2007-260
Vancouver dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. . 2021; 428 - 434. 10.3906/sag-2007-260
IEEE dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O "Clinical course of COVID-19 disease in immunosuppressed renal transplant patients." , ss.428 - 434, 2021. 10.3906/sag-2007-260
ISNAD dheir, hamad vd. "Clinical course of COVID-19 disease in immunosuppressed renal transplant patients". (2021), 428-434. https://doi.org/10.3906/sag-2007-260
APA dheir h, SİPAHİ S, YAYLACI S, ÇETİN E, Genc A, Firat N, Koroglu M, Muratdağı G, tomak y, ÖZMEN SÜNER K, Ateş Ö, KARABAY O (2021). Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. Turkish Journal of Medical Sciences, 51(2), 428 - 434. 10.3906/sag-2007-260
Chicago dheir hamad,SİPAHİ Savaş,YAYLACI SELÇUK,ÇETİN Esma Seda,Genc Ahmed Bilal,Firat Necattin,Koroglu Mehmet,Muratdağı Gürkan,tomak yakup,ÖZMEN SÜNER KEZBAN,Ateş Ömer Faruk,KARABAY OĞUZ Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. Turkish Journal of Medical Sciences 51, no.2 (2021): 428 - 434. 10.3906/sag-2007-260
MLA dheir hamad,SİPAHİ Savaş,YAYLACI SELÇUK,ÇETİN Esma Seda,Genc Ahmed Bilal,Firat Necattin,Koroglu Mehmet,Muratdağı Gürkan,tomak yakup,ÖZMEN SÜNER KEZBAN,Ateş Ömer Faruk,KARABAY OĞUZ Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. Turkish Journal of Medical Sciences, vol.51, no.2, 2021, ss.428 - 434. 10.3906/sag-2007-260
AMA dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. Turkish Journal of Medical Sciences. 2021; 51(2): 428 - 434. 10.3906/sag-2007-260
Vancouver dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O Clinical course of COVID-19 disease in immunosuppressed renal transplant patients. Turkish Journal of Medical Sciences. 2021; 51(2): 428 - 434. 10.3906/sag-2007-260
IEEE dheir h,SİPAHİ S,YAYLACI S,ÇETİN E,Genc A,Firat N,Koroglu M,Muratdağı G,tomak y,ÖZMEN SÜNER K,Ateş Ö,KARABAY O "Clinical course of COVID-19 disease in immunosuppressed renal transplant patients." Turkish Journal of Medical Sciences, 51, ss.428 - 434, 2021. 10.3906/sag-2007-260
ISNAD dheir, hamad vd. "Clinical course of COVID-19 disease in immunosuppressed renal transplant patients". Turkish Journal of Medical Sciences 51/2 (2021), 428-434. https://doi.org/10.3906/sag-2007-260