TY - JOUR
T1 - Outcomes of SOT Recipients with COVID-19 in Different Eras of COVID-19 Therapeutics
AU - Sait, Afrah S.
AU - Chiang, Teresa Po Yu
AU - Marr, Kieren A.
AU - Massie, Allan B.
AU - Cochran, Willa
AU - Shah, Pali
AU - Brennan, Daniel C.
AU - Thomas, Alvin G.
AU - Mehta Steinke, Seema
AU - Permpalung, Nitipong
AU - Shoham, Shmuel
AU - Merlo, Christian
AU - Jain, Tania
AU - Boyarsky, Brian
AU - Charnaya, Olga
AU - Gurakar, Ahmet
AU - Sharma, Kavita
AU - Durand, Christine M.
AU - Werbel, William A.
AU - Huang, Chiung Yu
AU - Ostrander, Darin
AU - Desai, Niraj
AU - Kim, Min Young
AU - Alasfar, Sami
AU - Bloch, Evan M.
AU - Tobian, Aaron A.R.
AU - Garonzik-Wang, Jacqueline
AU - Segev, Dorry L.
AU - Avery, Robin K.
N1 - Publisher Copyright:
© 2021 Wolters Kluwer Health. All rights reserved.
PY - 2021/12/23
Y1 - 2021/12/23
N2 - Background. Few reports have focused on newer coronavirus disease 2019 (COVID-19) therapies (remdesivir, dexamethasone, and convalescent plasma) in solid organ transplant recipients; concerns had been raised regarding possible adverse impact on allograft function or secondary infections. Methods. We studied 77 solid organ transplant inpatients with COVID-19 during 2 therapeutic eras (Era 1: March-May 2020, 21 patients; and Era 2: June-November 2020, 56 patients) and 52 solid organ transplant outpatients. Results. In Era 1, no patients received remdesivir or dexamethasone, and 4 of 21 (19.4%) received convalescent plasma, whereas in Era 2, remdesivir (24/56, 42.9%), dexamethasone (24/56, 42.9%), and convalescent plasma (40/56, 71.4%) were commonly used. Mortality was low across both eras, 4 of 77 (5.6%), and rejection occurred in only 2 of 77 (2.8%) inpatients; infections were similar in hypoxemic patients with or without dexamethasone. Preexisting graft dysfunction was associated with greater need for hospitalization, higher severity score, and lower survival. Acute kidney injury was present in 37.3% of inpatients; renal function improved more rapidly in patients who received remdesivir and convalescent plasma. Post-COVID-19 renal and liver function were comparable between eras, out to 90 d. Conclusions. Newer COVID-19 therapies did not appear to have a deleterious effect on allograft function, and infectious complications were comparable.
AB - Background. Few reports have focused on newer coronavirus disease 2019 (COVID-19) therapies (remdesivir, dexamethasone, and convalescent plasma) in solid organ transplant recipients; concerns had been raised regarding possible adverse impact on allograft function or secondary infections. Methods. We studied 77 solid organ transplant inpatients with COVID-19 during 2 therapeutic eras (Era 1: March-May 2020, 21 patients; and Era 2: June-November 2020, 56 patients) and 52 solid organ transplant outpatients. Results. In Era 1, no patients received remdesivir or dexamethasone, and 4 of 21 (19.4%) received convalescent plasma, whereas in Era 2, remdesivir (24/56, 42.9%), dexamethasone (24/56, 42.9%), and convalescent plasma (40/56, 71.4%) were commonly used. Mortality was low across both eras, 4 of 77 (5.6%), and rejection occurred in only 2 of 77 (2.8%) inpatients; infections were similar in hypoxemic patients with or without dexamethasone. Preexisting graft dysfunction was associated with greater need for hospitalization, higher severity score, and lower survival. Acute kidney injury was present in 37.3% of inpatients; renal function improved more rapidly in patients who received remdesivir and convalescent plasma. Post-COVID-19 renal and liver function were comparable between eras, out to 90 d. Conclusions. Newer COVID-19 therapies did not appear to have a deleterious effect on allograft function, and infectious complications were comparable.
UR - http://www.scopus.com/inward/record.url?scp=85122566228&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85122566228&partnerID=8YFLogxK
U2 - 10.1097/TXD.0000000000001268
DO - 10.1097/TXD.0000000000001268
M3 - Article
C2 - 34966840
AN - SCOPUS:85122566228
SN - 2373-8731
VL - 8
SP - E1268
JO - Transplantation Direct
JF - Transplantation Direct
IS - 1
ER -