COVID-19 in transplant recipients: The Spanish experience

被引：152

作者：

Coll, Elisabeth ^{[1
]}

Fernandez-Ruiz, Mario ^{[2
,3
]}

Sanchez-Alvarez, J. Emilio ^{[4
,5
]}

Martinez-Fernandez, Jose R. ^{[1
]}

Crespo, Marta ^{[6
,7
,8
]}

Gayoso, Jorge ^{[1
]}

Bada-Bosch, Teresa ^{[9
]}

Oppenheimer, Federico ^{[10
]}

Moreso, Francesc ^{[11
]}

Lopez-Oliva, Maria O. ^{[12
]}

Melilli, Edoardo ^{[13
]}

Rodriguez-Ferrero, Marisa L. ^{[14
]}

Bravo, Carlos ^{[15
]}

Burgos, Elena ^{[16
]}

Facundo, Carme ^{[17
]}

Lorenzo, Inmaculada ^{[18
]}

Yanez, Inigo ^{[19
]}

Galeano, Cristina ^{[20
]}

Roca, Ana ^{[21
]}

Cabello, Mercedes ^{[22
]}

Gomez-Bueno, Manuel ^{[23
]}

Garcia-Cosio, Ma Dolores ^{[24
,25
]}

Graus, Javier ^{[26
]}

Llado, Laura ^{[27
]}

de Pablo, Alicia ^{[28
]}

Loinaz, Carmelo ^{[29
]}

Aguado, Beatriz ^{[30
]}

Hernandez, Domingo ^{[31
,32
,33
]}

Dominguez-Gil, Beatriz ^{[1
]}

机构：

[1] Spanish Natl Transplant Org, Org Nacl Trasplantes, Madrid, Spain

[2] Hosp Univ 12 Octubre, Grp Study Infect Transplantat & Immunocompromised, Spanish Soc Infect Dis & Clin Microbiol SEIMC, Unit Infect Dis,Inst Invest Sanitaria,imas12, Madrid, Spain

[3] Spanish Soc Infect Dis & Clin Microbiol SEIMC, Grp Study Infect Transplantat & Immunocompromi, Madrid, Spain

[4] Hosp Univ Cabuenes, Dept Nephrol, Gijon, Spain

[5] Spanish Soc Nephrol SEN, Gijon, Spain

[6] Hosp del Mar, Dept Nephrol, Barcelona, Spain

[7] Spanish Soc Nephrol SEN, Transplant Working Grp, Barcelona, Spain

[8] REDinREN RD16 0009 0013, Barcelona, Spain

[9] Hosp Univ 12 Octubre, Dept Nephrol, Madrid, Spain

[10] Hosp Clin Barcelona, Dept Nephrol, Barcelona, Spain

[11] Hosp Univ Vall dHebron, Dept Nephrol, Kidney Transplant Unit, Barcelona, Spain

[12] Hosp Univ La Paz, Dept Nephrol, Madrid, Spain

[13] Hosp Univ Bellvitge, Dept Nephrol, Kidney Transplant Unit, Barcelona, Spain

[14] Hosp Gen Univ Gregorio Maranon, Dept Nephrol, Madrid, Spain

[15] Hosp Univ Vall dHebron, Lung Transplant Unit, Dept Pulmonol, Barcelona, Spain

[16] Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Badalona, Spain

[17] Fdn Puigvert, Kidney Transplant Unit, Barcelona, Spain

[18] Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain

[19] Hosp Univ Cruces, Dept Nephrol, Baracaldo, Spain

[20] Hosp Univ Ramon y Cajal, Kidney Transplant Unit, Madrid, Spain

[21] Complejo Hosp Univ Toledo, Dept Nephrol, Toledo, Spain

[22] Hosp Reg Univ Malaga, Dept Nephrol, Malaga, Spain

[23] Hosp Univ Puerta Hierro, Dept Cardiol, Madrid, Spain

[24] Hosp Univ 12 Octubre, Inst Invest Sanitaria, Hosp 12 Octubre, Cardiol Serv,imas12, Madrid, Spain

[25] Ctr Invest Biomed Red Cardiovasc CIBERCV, Madrid, Spain

[26] Hosp Univ Ramon y Cajal, Dept Gastroenterol, Madrid, Spain

[27] Hosp Univ Bellvitge, Liver Transplant Unit, Barcelona, Spain

[28] Hosp Univ 12 Octubre, Dept Pneumol, Lung Transplant Unit, Madrid, Spain

[29] Hosp Univ 12 Octubre, Dept Gen Surg Digest Tract & Abdominal Organ Tran, Transplant Unit, Madrid, Spain

[30] Hosp Univ La Princesa, Transplant Unit, Dept Hematol, Madrid, Spain

[31] Hosp Reg Univ, Dept Nephrol, Malaga, Spain

[32] Inst Invest Biomed Malaga IBIMA, Malaga, Spain

[33] Spanish Soc Transplantat SET, Malaga, Spain

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2021年 / 21卷 / 05期

关键词：

clinical research; practice; infectious disease; infection and infectious agents ‐ viral; antibiotic; antiviral; clinical decision‐ making; complication; infectious; CORONAVIRUS DISEASE 2019; CLINICAL IMPACT; INFECTION;

D O I：

10.1111/ajt.16369

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-beta (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).

引用

页码：1825 / 1837

页数：13

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