SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience

Detalhes bibliográficos
Autor(a) principal: Santos,Afonso
Data de Publicação: 2022
Outros Autores: Sousa,Luís Leite de, Calça,Rita, Lima,Anna, Nascimento,Célia, Jorge,Cristina, Adragão,Teresa, Bruges,Margarida, Peres,Susana, Weigert,André
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000300376
Resumo: ABSTRACT Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection. Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period. Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%. Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.
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spelling SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experienceKidney TransplantationCOVID-19AntiviralsABSTRACT Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection. Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period. Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%. Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.Sociedade Brasileira de Nefrologia2022-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000300376Brazilian Journal of Nephrology v.44 n.3 2022reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2021-0164info:eu-repo/semantics/openAccessSantos,AfonsoSousa,Luís Leite deCalça,RitaLima,AnnaNascimento,CéliaJorge,CristinaAdragão,TeresaBruges,MargaridaPeres,SusanaWeigert,Andréeng2022-09-23T00:00:00Zoai:scielo:S0101-28002022000300376Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2022-09-23T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
title SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
spellingShingle SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
Santos,Afonso
Kidney Transplantation
COVID-19
Antivirals
title_short SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
title_full SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
title_fullStr SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
title_full_unstemmed SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
title_sort SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience
author Santos,Afonso
author_facet Santos,Afonso
Sousa,Luís Leite de
Calça,Rita
Lima,Anna
Nascimento,Célia
Jorge,Cristina
Adragão,Teresa
Bruges,Margarida
Peres,Susana
Weigert,André
author_role author
author2 Sousa,Luís Leite de
Calça,Rita
Lima,Anna
Nascimento,Célia
Jorge,Cristina
Adragão,Teresa
Bruges,Margarida
Peres,Susana
Weigert,André
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Santos,Afonso
Sousa,Luís Leite de
Calça,Rita
Lima,Anna
Nascimento,Célia
Jorge,Cristina
Adragão,Teresa
Bruges,Margarida
Peres,Susana
Weigert,André
dc.subject.por.fl_str_mv Kidney Transplantation
COVID-19
Antivirals
topic Kidney Transplantation
COVID-19
Antivirals
description ABSTRACT Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection. Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period. Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%. Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.
publishDate 2022
dc.date.none.fl_str_mv 2022-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000300376
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2021-0164
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.44 n.3 2022
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
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institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
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repository.mail.fl_str_mv ||jbn@sbn.org.br
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