Abstract
Background: Kidney transplant recipients (KTR) are considered high-risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). However, some studies did not show worse outcomes compared to non-transplant patients and there is little data about immunosuppressant drug levels and secondary infections in KTR with COVID-19. Herein, we describe our single-center experience with COVID-19 in KTR.
Methods: We captured KTR diagnosed with COVID-19 between March 1, 2020 and May 18, 2020. After exclusion of KTR on hemodialysis and off immunosuppression, we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by age and sex (controls).
Results: Eleven KTR were hospitalized and matched with 44 controls. One KTR and 4 controls died (case fatality rate: 9.1%). There were no significant differences in length of stay or clinical outcomes between KTR and controls. Tacrolimus or sirolimus levels were >10 ng/mL in 6 out of 9 KTR (67%). Bacterial infections were more frequent in KTR (36.3%), compared with controls (6.8%, P = .02).
Conclusions: In our small case series, unlike earlier reports from the pandemic epicenters, the clinical outcomes of KTR with COVID-19 were comparable to those of non-transplant patients. Calcineurin or mammalian target of rapamycin inhibitor (mTOR) levels were high. Bacterial infections were more common in KTR, compared with controls.
【초록키워드】 COVID-19, coronavirus disease, Coronavirus disease 2019, pandemic, Hospitalized, Infection, Immunosuppression, outcome, clinical outcomes, Clinical outcome, Rapamycin, Clinical course, Case series, Hemodialysis, Secondary infection, morbidity, Case fatality rate, Control, morbidity and mortality, inhibitor, Bacterial infections, secondary infections, tacrolimus, fatality, Sirolimus, kidney transplant recipients, mTOR, no significant differences, no significant difference, non-transplant patients, single-center, exclusion, recipient, calcineurin, mammalian, controls, died, comparable, age and sex, diagnosed with COVID-19, drug level, non-transplant patient, with COVID-19, 【제목키워드】 Transplant, experience,