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Title: Risk factors for unfavorable outcome and impact of early post-transplant infection in solid organ recipients with COVID-19: A prospective multicenter cohort study
Author: Salto Alejandre, Sonsoles
Jiménez Jorge, Silvia
Sabé, Nuria
Ramos Martínez, Antonio
Linares, Laura
Valerio, Maricela
Martín Dávila, Pilar
Fernández Ruiz, Mario
Fariñas, María Carmen
Blanes Juliá, Marino
Vidal, Elisa
Palacios Baena, Zaira R.
Hernández Gallego, Román
Carratalà, Jordi
Calderón Parra, Jorge
Marcos, María Ángeles
Muñoz, Patricia
Fortún Abete, Jesús
Aguado, José María
Arnaiz Revillas, Francisco
Blanes Hernández, Rosa
Torre Cisneros, Julián de la
López Cortés, Luis E.
García de Vinuesa Calvo, Elena
Rosso, Clara M.
Pachón, Jerónimo
Sánchez Céspedes, Javier
Cordero, Elisa
The Covidsot Working Team
Keywords: COVID-19
Factors de risc en les malalties
Trasplantament d'òrgans
Risk factors in diseases
Transplantation of organs
Issue Date: 29-Apr-2021
Publisher: Public Library of Science (PLoS)
Abstract: The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of 210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193/200 (96.5%), lopinavir/ritonavir 91/200 (45.5%), and tocilizumab 49/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death: advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant period.
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It is part of: PLOS ONE, 2021, vol. 16, num. 4, p. e0250796
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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