Clinical outcomes and serologic response in solid organ transplant recipients with COVID-19: A case series from the United States

The coronavirus disease 2019 (COVID‐19) pandemic caused by SARS coronavirus 2 (SARS‐CoV‐2) has caused significant morbidity and mortality for patients and stressed healthcare systems worldwide. The clinical features, disease course, and serologic response of COVID‐19 among immunosuppressed patients such as solid organ transplant (SOT) recipients, who are at presumed risk for more severe disease, are not well characterized. We describe our institutional experience with COVID‐19 among 10 SOT patients, including the clinical presentation, treatment modalities, and outcomes of 7 renal transplant recipients, 1 liver transplant recipient, 1 heart transplant recipient, and 1 lung transplant recipient. In addition, we report the serologic response in SOT recipients, documenting a positive IgG response in all 7 hospitalized patients. We also review the existing literature on COVID‐19 in SOT recipients to consolidate the current knowledge on COVID‐19 in the SOT population for the transplant community.

[1]  D. Goldfarb Re: COVID-19 in Solid Organ Transplant Recipients: Initial Report from the US Epicenter. , 2020, The Journal of urology.

[2]  E. Akalin,et al.  Covid-19 and Kidney Transplantation , 2020, The New England journal of medicine.

[3]  S. Mohan Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York. , 2020, Journal of the American Society of Nephrology : JASN.

[4]  Bin Liu,et al.  Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients: A Summary of 10 Confirmed Cases in Wuhan, China , 2020, European Urology.

[5]  Lynnette Brammer,et al.  Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[6]  B. Koçak,et al.  Case report: A kidney transplant patient with mild COVID‐19 , 2020, Transplant infectious disease : an official journal of the Transplantation Society.

[7]  J. Aguado,et al.  COVID-19 in solid organ transplant recipients: A single-center case series from Spain , 2020, American Journal of Transplantation.

[8]  A. De Maria,et al.  Immunosuppressive therapy maintenance in a kidney transplant recipient with SARS-CoV-2 pneumonia: A case report , 2020, American Journal of Transplantation.

[9]  W. Zhou,et al.  Clinical characteristics and immunosuppressant management of coronavirus disease 2019 in solid organ transplant recipients , 2020, American Journal of Transplantation.

[10]  Shengyu Zhang,et al.  Novel coronavirus (SARS-CoV-2) infection in a renal transplant recipient: Case report , 2020, American Journal of Transplantation.

[11]  Anna Stachel,et al.  Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  V. Mazzaferro,et al.  COVID-19 in long-term liver transplant patients: preliminary experience from an Italian transplant centre in Lombardy , 2020, The Lancet Gastroenterology & Hepatology.

[13]  D. Mathieu,et al.  High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2) Requiring Invasive Mechanical Ventilation , 2020, Obesity.

[14]  Xiao-qiang Wu,et al.  COVID-19 in a Kidney Transplant Patient , 2020, European Urology.

[15]  Tianbing Wang,et al.  Detection of antibodies against SARS‐CoV‐2 in patients with COVID‐19 , 2020, Journal of medical virology.

[16]  R. Bruno,et al.  SARS Cov-2 infection in a renal-transplanted patient: A case report , 2020, American Journal of Transplantation.

[17]  Emily N. Ussery,et al.  Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[18]  O. Tsang,et al.  Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study , 2020, The Lancet Infectious Diseases.

[19]  Qi Jin,et al.  Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19) , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  P. Mehta,et al.  COVID-19: consider cytokine storm syndromes and immunosuppression , 2020, The Lancet.

[21]  J. Xiang,et al.  Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study , 2020, The Lancet.

[22]  K. Yuen,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The New England journal of medicine.

[23]  Lei Liu,et al.  Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019 , 2020, medRxiv.

[24]  Zunyou Wu,et al.  Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. , 2020, JAMA.

[25]  E. Dong,et al.  An interactive web-based dashboard to track COVID-19 in real time , 2020, The Lancet Infectious Diseases.

[26]  Ruchong Chen,et al.  Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China , 2020, The Lancet Oncology.

[27]  Yan Zhao,et al.  Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. , 2020, JAMA.

[28]  O. Manuel,et al.  RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice , 2019, Clinical transplantation.

[29]  J. Enders,et al.  Infectious Diseases Society of America. , 1969, Antimicrobial agents and chemotherapy.

[30]  Y. Xiong,et al.  Clinical characteristics and immunosuppressants management of coronavirus disease 2019 in solid organ transplant recipients , 2020 .