Attenuated early inflammatory response in solid organ recipients with COVID-19.

Abstract:

:Immunosuppression leaves transplanted patients at particular risk for severe acute respiratory syndrome 2 (SARS-CoV-2) infection. The specific features of coronavirus disease 2019 (COVID-19) in immunosuppressed patients are largely unknown and therapeutic experience is lacking. Seven transplanted patients (two liver, three kidneys, one double lung, one heart) admitted to the Ludwig-Maximilians-University Munich because of COVID-19 and tested positive for SARS-CoV-2 were included. The clinical course and the clinical findings were extracted from the medical record. The two liver transplant patients and the heart transplant patient had an uncomplicated course and were discharged after 14, 18, and 12 days, respectively. Two kidney transplant recipients were intubated within 48 hours. One kidney and the lung transplant recipients were required to intubate after 10 and 15 days, respectively. Immunosuppression was adapted in five patients, but continued in all patients. Compared to non-transplanted patients at the ICU (n = 19) the inflammatory response was attenuated in transplanted patients, which was proven by decreased IL-6 blood values. This analysis might provide evidence that continuous immunosuppression is safe and probably beneficial since there was no hyperinflammation evident. Although transplanted patients might be more susceptible to an infection with SARS-CoV-2, their clinical course seems to be similar to immunocompetent patients.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Bösch F,Börner N,Kemmner S,Lampert C,Jacob S,Koliogiannis D,Stangl M,Michel S,Kneidinger N,Schneider C,Fischereder M,Irlbeck M,Denk G,Werner J,Angele MK,Guba MO

doi

10.1111/ctr.14027

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

e14027

issue

10

eissn

0902-0063

issn

1399-0012

journal_volume

34

pub_type

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