SARS-CoV-2 infection in transplant recipients: experience of a COVID-19 unit in Portugal
Immunosuppression (IS) is considered a risk factor for severe COVID-19. It remains unclear if solid organ transplantation (SOT) affects its presentation or outcome. We aimed to describe the clinical course of SOT recipients hospitalized due to SARS-CoV-2 infection. Hospitalizations due to COVID-19 in the Infectious Diseases Department from March 2020 to January 2021 were reviewed, and SOT recipients were selected. Seventeen patients (pts) were included, 13 of which were male, with a median age of 58 years. Transplanted organs were kidney (n=11, of which 2 were kidney-pancreas), liver (n=4), and lung (n=2). Mean post-transplant time was 83.8 months (SD 99.2). Main comorbidities were diabetes (n=13), hypertension (n=13) and obesity (n=6). Fever (n=12, 71%) and cough (n=10, 59%) were the most common symptoms. Ten pts developed hypoxemic pneumonia, five required invasive mechanical ventilation (IMV), one required dialysis and three died during hospitalization. Before admission, most pts (n=9) were on prednisolone (PDN), tacrolimus and mycophenolate (MP). In most pts, MP was stopped and PDN was started or its dosage increased, to the equivalent of 6 mg dexamethasone if indicated. IS was not adjusted in five pts (29%). Antimetabolites are stopped to prevent lymphopenia, and calcineurin inhibitors are maintained to inhibit IL-6 and IL-1 pathways. The presence of known risk factors for severity in most pts makes impact of SOT difficult to assess. Other series of SOT recipients hospit...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Oliveira Pinto, M. A., Fernandes, S., Rodrigues, J., Pinto, A. R., Leal, E., Torres, M., Betkova, S., Goncalves, R., Santos, A. S., Lino, S., Semedo, L., Cardoso, J., Maltez, F. Tags: Respiratory infections and bronchiectasis Source Type: research
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