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COVID‐19 in elderly kidney transplant recipients
Author(s) -
Crespo Marta,
PérezSáez María J.,
RedondoPachón Dolores,
LlinàsMallol Laura,
Montero María M.,
VillarGarcía Judith,
AriasCabrales Carlos,
Buxeda Anna,
Burballa Carla,
Vázquez Susana,
López Thais,
Moreno Fátima,
Mir Marisa,
Outón Sara,
Sierra Adriana,
Collado Silvia,
Barrios Clara,
Rodríguez Eva,
Sans Laia,
Barbosa Francesc,
Cao Higini,
Arenas María D.,
GüerriFernández Roberto,
Horcajada Juan P.,
Pascual Julio
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.16096
Subject(s) - medicine , hydroxychloroquine , population , case fatality rate , azithromycin , pneumonia , kidney disease , mortality rate , tocilizumab , tacrolimus , pediatrics , transplantation , disease , infectious disease (medical specialty) , covid-19 , epidemiology , environmental health , microbiology and biotechnology , biology , antibiotics
The SARS‐Cov‐2 infection disease (COVID‐19) pandemic has posed at risk the kidney transplant (KT) population, particularly the elderly recipients. From March 12 until April 4, 2020, we diagnosed COVID‐19 in 16 of our 324 KT patients aged ≥65 years old (4.9%). Many of them had had contact with healthcare facilities in the month prior to infection. Median time of symptom onset to admission was 7 days. All presented with fever and all but one with pneumonia. Up to 33% showed renal graft dysfunction. At infection diagnosis, mTOR inhibitors or mycophenolate were withdrawn. Tacrolimus was withdrawn in 70%. The main treatment combination was hydroxychloroquine and azithromycin. A subset of patients was treated with anti‐retroviral and tocilizumab. Short‐term fatality rate was 50% at a median time since admission of 3 days. Those who died were more frequently obese, frail, and had underlying heart disease. Although a higher respiratory rate was observed at admission in nonsurvivors, symptoms at presentation were similar between both groups. Patients who died were more anemic, lymphopenic, and showed higher D‐dimer, C‐reactive protein, and IL‐6 at their first tests. COVID‐19 is frequent among the elderly KT population and associates a very early and high mortality rate.

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