COVID-19 in Solid Organ Transplant Recipient: Exploring Cumulative Incidence, Seroprevalence and Risk Factors for Disease Severity.

Autor:	Caldara R; Clinical Transplant Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Maffi P; Clinical Transplant Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy., Costa S; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Bazzigaluppi E; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Brigatti C; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Lampasona V; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Magistretti P; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Manenti F; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Marzinotto I; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Pellegrini S; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Scavini M; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Secchi A; Clinical Transplant Unit, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy., Piemonti L; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy.; Diabetes Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.
Jazyk:	angličtina
Zdroj:	Biology [Biology (Basel)] 2021 Dec 18; Vol. 10 (12). Date of Electronic Publication: 2021 Dec 18.
DOI:	10.3390/biology10121349
Abstrakt:	Background: Solid organ transplant (SOT) recipients may be at increased risk for severe disease and mortality from COVID-19 because of immunosuppression and prolonged end-stage organ disease. As a transplant center serving a diverse patient population, we report the cumulative incidence and outcomes of SARS-CoV-2 infection in our cohort of SOT recipients. Methods: We prospectively included in this observational study SOT recipients with a functioning kidney ( n = 201), pancreas ± kidney ( n = 66) or islet transplant ( n = 24), attending outpatient regular follow-up at the San Raffaele Hospital from February 2020 to April 2021. Antibodies to SARS-CoV-2 were tested in all patients by a luciferase immunoprecipitation system assay. Results: Of the 291 SOT recipients, 30 (10.3%) tested positive for SARS-CoV-2 during the study period and prevalence was not different among different transplants. The SARS-CoV-2 antibody frequency was around 2.6-fold higher than the incidence of cases who tested positive for SARS-CoV-2 RT-PCR. As for the WHO COVID-19 severity classification, 19 (63.3%) SOT recipients were mild, nine (30%) were moderate, and two were critical and died yielding a crude mortality rate in our patient population of 6.7%. Kidney transplant (OR 12.9 (1.1-150) p = 0.041) was associated with an increased risk for moderate/critical disease, while statin therapy (OR 0.116 (0.015-0.926) p = 0.042) and pancreas/islet transplant (OR 0.077 (0.007-0.906) p = 0.041) were protective. Conclusions: The incidence of SARS-CoV-2 infection in SOT recipients may be higher than previously described. Due to the relative high crude mortality, symptomatic SOT recipients must be considered at high risk in case of SARS-CoV-2 infection.
Databáze:	MEDLINE
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