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COVID‐19 in solid organ transplant recipients: Initial report from the US epicenter
Author(s) -
Pereira Marcus R.,
Mohan Sumit,
Cohen David J.,
Husain Syed A.,
Dube Geoffrey K.,
Ratner Lloyd E.,
Arcasoy Selim,
Aversa Meghan M.,
Benvenuto Luke J.,
Dadhania Darshana M.,
Kapur Sandip,
Dove Lorna M.,
Brown Robert S.,
Rosenblatt Russell E.,
Samstein Benjamin,
Uriel Nir,
Farr Maryjane A.,
Satlin Michael,
Small Catherine B.,
Walsh Thomas J.,
Kodiyanplakkal Rosy P.,
Miko Benjamin A.,
Aaron Justin G.,
Tsapepas Demetra S.,
Emond Jean C.,
Verna Elizabeth C.
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15941
Subject(s) - medicine , asymptomatic , azithromycin , tocilizumab , organ transplantation , hydroxychloroquine , transplantation , infectious disease (medical specialty) , disease , covid-19 , microbiology and biotechnology , biology , antibiotics
Solid organ transplant recipients may be at a high risk for SARS‐CoV‐2 infection and poor associated outcomes. We herein report our initial experience with solid organ transplant recipients with SARS‐CoV‐2 infection at two centers during the first 3 weeks of the outbreak in New York City. Baseline characteristics, clinical presentation, antiviral and immunosuppressive management were compared between patients with mild/moderate and severe disease (defined as ICU admission, intubation or death). Ninety patients were analyzed with a median age of 57 years. Forty‐six were kidney recipients, 17 lung, 13 liver, 9 heart, and 5 dual‐organ transplants. The most common presenting symptoms were fever (70%), cough (59%), and dyspnea (43%). Twenty‐two (24%) had mild, 41 (46%) moderate, and 27 (30%) severe disease. Among the 68 hospitalized patients, 12% required non‐rebreather and 35% required intubation. 91% received hydroxychloroquine, 66% azithromycin, 3% remdesivir, 21% tocilizumab, and 24% bolus steroids. Sixteen patients died (18% overall, 24% of hospitalized, 52% of ICU) and 37 (54%) were discharged. In this initial cohort, transplant recipients with COVID‐19 appear to have more severe outcomes, although testing limitations likely led to undercounting of mild/asymptomatic cases. As this outbreak unfolds, COVID‐19 has the potential to severely impact solid organ transplant recipients.