COVID-19 in elderly kidney transplant recipients #MMPMID32471001
Crespo M; Perez-Saez MJ; Redondo-Pachon D; Llinas-Mallol L; Montero MM; Villar-Garcia J; Arias-Cabrales C; Buxeda A; Burballa C; Vazquez S; Lopez T; Moreno F; Mir M; Outon S; Sierra A; Collado S; Barrios C; Rodriguez E; Sans L; Barbosa F; Cao H; Arenas MD; Guerri-Fernandez R; Horcajada JP; Pascual J
Am J Transplant 2020[Oct]; 20 (10): 2883-2889 PMID32471001show ga
The SARS-Cov-2 infection disease (COVID-19) pandemic has posed at risk the kidney transplant (KT) population, particularly the elderly recipients. From March 12 until April 4, 2020, we diagnosed COVID-19 in 16 of our 324 KT patients aged >/=65 years old (4.9%). Many of them had had contact with healthcare facilities in the month prior to infection. Median time of symptom onset to admission was 7 days. All presented with fever and all but one with pneumonia. Up to 33% showed renal graft dysfunction. At infection diagnosis, mTOR inhibitors or mycophenolate were withdrawn. Tacrolimus was withdrawn in 70%. The main treatment combination was hydroxychloroquine and azithromycin. A subset of patients was treated with anti-retroviral and tocilizumab. Short-term fatality rate was 50% at a median time since admission of 3 days. Those who died were more frequently obese, frail, and had underlying heart disease. Although a higher respiratory rate was observed at admission in nonsurvivors, symptoms at presentation were similar between both groups. Patients who died were more anemic, lymphopenic, and showed higher D-dimer, C-reactive protein, and IL-6 at their first tests. COVID-19 is frequent among the elderly KT population and associates a very early and high mortality rate.
free
free
free
Am+J+Transplant 2020 ; 20 (10): 2883-2889
