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Early experience with COVID-19 in kidney transplantation recipients: update and review
INTRODUCTION: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. PURPOSE: to provide an updated view regarding the early experience obtained from the management of KTRs with CO...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719977/ https://www.ncbi.nlm.nih.gov/pubmed/32550702 http://dx.doi.org/10.1590/S1677-5538.IBJU.2020.S114 |
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author | González, Javier Ciancio, Gaetano |
author_facet | González, Javier Ciancio, Gaetano |
author_sort | González, Javier |
collection | PubMed |
description | INTRODUCTION: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. PURPOSE: to provide an updated view regarding the early experience obtained from the management of KTRs with COVID-19. MATERIALS AND METHODS: A narrative review was conducted using PubMed database to identify relevant articles written in English/Spanish, and published through May 15, 2020. Search terms included: “coronavirus”, “severe acute respiratory syndrome coronavirus 2”, “SARS-CoV-2”, “COVID-19”, “COVID”, “renal transplantation”, and “kidney transplantation”. Case series were considered eligible, and case reports excluded. Thirty-four articles were included in the review. RESULTS: KTRs should be considered immunocompromised hosts: potential risk for infection, non-negligible comorbidity, and exposure to long-term immunosuppression. Only single center small retrospective experiences are still available regarding KTRs with COVID-19. SARS-CoV-2 symptoms in KTRs are similar to that observed for the general population, being fever and cough the most frequently observed. Mild-to-moderate symptomatic KTRs can be managed in an outpatient setting, while patients exhibiting severe symptoms must be addmited to hospital. More rapid clinical progression, and higher complication and death rates have been observed for hospitalized KTRs, requiring hemodyalisis or ventilatory support. Lymphopenia, elevated serum markers (C-reactive protein, procalcitonin, IL-6, D-dimer), and chest-X-ray findings consistent with pneumonia are linked to worse prognosis. A number of antiviral therapies have been used. However, it is difficult to draw meaningful conclusions regarding their efficacy at this point. Baseline immunosupression regimen should be adjusted in a case-by-case manner. However, it poses a significant challenge. |
format | Online Article Text |
id | pubmed-7719977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-77199772020-12-11 Early experience with COVID-19 in kidney transplantation recipients: update and review González, Javier Ciancio, Gaetano Int Braz J Urol Original Article INTRODUCTION: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. PURPOSE: to provide an updated view regarding the early experience obtained from the management of KTRs with COVID-19. MATERIALS AND METHODS: A narrative review was conducted using PubMed database to identify relevant articles written in English/Spanish, and published through May 15, 2020. Search terms included: “coronavirus”, “severe acute respiratory syndrome coronavirus 2”, “SARS-CoV-2”, “COVID-19”, “COVID”, “renal transplantation”, and “kidney transplantation”. Case series were considered eligible, and case reports excluded. Thirty-four articles were included in the review. RESULTS: KTRs should be considered immunocompromised hosts: potential risk for infection, non-negligible comorbidity, and exposure to long-term immunosuppression. Only single center small retrospective experiences are still available regarding KTRs with COVID-19. SARS-CoV-2 symptoms in KTRs are similar to that observed for the general population, being fever and cough the most frequently observed. Mild-to-moderate symptomatic KTRs can be managed in an outpatient setting, while patients exhibiting severe symptoms must be addmited to hospital. More rapid clinical progression, and higher complication and death rates have been observed for hospitalized KTRs, requiring hemodyalisis or ventilatory support. Lymphopenia, elevated serum markers (C-reactive protein, procalcitonin, IL-6, D-dimer), and chest-X-ray findings consistent with pneumonia are linked to worse prognosis. A number of antiviral therapies have been used. However, it is difficult to draw meaningful conclusions regarding their efficacy at this point. Baseline immunosupression regimen should be adjusted in a case-by-case manner. However, it poses a significant challenge. Sociedade Brasileira de Urologia 2020-07-27 /pmc/articles/PMC7719977/ /pubmed/32550702 http://dx.doi.org/10.1590/S1677-5538.IBJU.2020.S114 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article González, Javier Ciancio, Gaetano Early experience with COVID-19 in kidney transplantation recipients: update and review |
title | Early experience with COVID-19 in kidney transplantation recipients: update and review |
title_full | Early experience with COVID-19 in kidney transplantation recipients: update and review |
title_fullStr | Early experience with COVID-19 in kidney transplantation recipients: update and review |
title_full_unstemmed | Early experience with COVID-19 in kidney transplantation recipients: update and review |
title_short | Early experience with COVID-19 in kidney transplantation recipients: update and review |
title_sort | early experience with covid-19 in kidney transplantation recipients: update and review |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719977/ https://www.ncbi.nlm.nih.gov/pubmed/32550702 http://dx.doi.org/10.1590/S1677-5538.IBJU.2020.S114 |
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