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  • Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China #MMPMID32317180
  • Zhu L; Gong N; Liu B; Lu X; Chen D; Chen S; Shu H; Ma K; Xu X; Guo Z; Lu E; Chen D; Ge Q; Cai J; Jiang J; Wei L; Zhang W; Chen G; Chen Z
  • Eur Urol 2020[Jun]; 77 (6): 748-754 PMID32317180show ga
  • 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.
  • |*Immunocompromised Host[MESH]
  • |*Transplant Recipients[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Antiviral Agents/*administration & dosage/adverse effects[MESH]
  • |Betacoronavirus/*drug effects/immunology/isolation & purification[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Testing[MESH]
  • |China[MESH]
  • |Clinical Laboratory Techniques[MESH]
  • |Coronavirus Infections/diagnosis/*drug therapy/mortality/virology[MESH]
  • |Female[MESH]
  • |Glucocorticoids/*administration & dosage/adverse effects[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/administration & dosage/*adverse effects[MESH]
  • |Kidney Transplantation/*adverse effects/mortality[MESH]
  • |Male[MESH]
  • |Methylprednisolone/*administration & dosage/adverse effects[MESH]
  • |Middle Aged[MESH]
  • |Noninvasive Ventilation[MESH]
  • |Opportunistic Infections/*drug therapy/mortality/therapy/virology[MESH]
  • |Oxygen Inhalation Therapy[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*drug therapy/mortality/virology[MESH]
  • |Predictive Value of Tests[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]
  • |Time Factors[MESH]
  • |Treatment Outcome[MESH]
  • |Virus Shedding[MESH]
  • |Young Adult[MESH]

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  • suck abstract from ncbi

    748 6.77 2020