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: Tags: Respiratory infections and bronchiectasis Source Type: research