COVID‐19 in solid organ transplant recipients: A single‐center case series from Spain |
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Authors: | Mario Fernndez‐Ruiz Amado Andrs Carmelo Loinaz Juan F Delgado Francisco Lpez‐Medrano Rafael San Juan Esther Gonzlez Natalia Polanco María D Folgueira Antonio Lalueza Carlos Lumbreras Jos M Aguado |
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Institution: | Mario Fernández‐Ruiz,Amado Andrés,Carmelo Loinaz,Juan F. Delgado,Francisco López‐Medrano,Rafael San Juan,Esther González,Natalia Polanco,María D. Folgueira,Antonio Lalueza,Carlos Lumbreras,José M. Aguado |
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Abstract: | The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney 44.4%], liver 33.3%], and heart 22.2%]) recipients diagnosed with COVID‐19 by March 23, 2020 at a tertiary‐care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon‐β (16.7%). As of April 4, the case‐fatality rate was 27.8% (5/18). After a median follow‐up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C‐reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS‐CoV‐2 infection has a severe course in SOT recipients. |
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Keywords: | coronavirus COVID‐19 outcome SARS‐CoV‐2 solid organ transplantation treatment |
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