A retrospective matched cohort single-center study evaluating outcomes of COVID-19 and the impact of immunomodulation on COVID-19-related cytokine release syndrome in solid organ transplant recipients.

Autor: Ringer M; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA., Azmy V; Department of Internal Medicine, Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA., Kaman K; Department of Internal Medicine, Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA., Tang D; School of Public Health, Yale University, New Haven, CT, USA., Cheung H; Yale School of Medicine, New Haven, CT, USA., Azar MM; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA., Price C; Department of Internal Medicine, Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA.; Department of Internal Medicine, Section of Allergy and Clinical Immunology, VA Medical Center, New Haven, CT, USA., Malinis M; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2021 Apr; Vol. 23 (2), pp. e13556. Date of Electronic Publication: 2021 Jan 22.
DOI: 10.1111/tid.13556
Abstrakt: This retrospective matched cohort study describes 30 solid organ transplant (SOT) patients with Coronavirus Disease 2019 (COVID-19) matched 1:2 to 60 non-SOT patients (control group) based on age, body mass index (BMI), and comorbidities (hypertension and diabetes mellitus with hemoglobin A1c > 8.0%). The SOT group had a higher proportion of cardiovascular disease (P < .05). During the index hospitalization, there were no significant differences with regard to disease severity or critical care needs (mechanical intubation, vasopressors, and renal replacement therapy). At 28 days, 4 (13%) patients died in the SOT group and 8 (13%) patients died in the control group (P = 1.0). Nineteen patients received tocilizumab in the SOT group compared to 29 patients in the control group. Among these patients, interleukin-6 (IL-6) and soluble interleukin-2 receptor (sIL2R) levels increased after tocilizumab and interleukin-10 (IL-10) levels decreased after tocilizumab. Overall, SOT patients had comparable mortality to non-SOT patients, although numerically more SOT patients received tocilizumab (63% vs 48%) and steroids (37% vs 20%). Larger, multi-center studies are needed to ascertain these findings. Lastly, the complex cytokine release syndrome in COVID-19 remains an area of intense research and the analysis of key interleukin levels (IL-6, IL-10, and sIL2R) in this study contributes to the understanding of this process.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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