RT Journal Article
T1 Respiratory and Gastrointestinal COVID-19 Phenotypes in Kidney Transplant Recipients.
A1 Crespo, Marta
A1 Mazuecos, Auxiliadora
A1 Rodrigo, Emilio
A1 Gavela, Eva
A1 Villanego, Florentino
A1 Sanchez-Alvarez, Emilio
A1 Gonzalez-Monte, Esther
A1 Jimenez-Martin, Carlos
A1 Melilli, Edoardo
A1 Diekman, Fritz
A1 Zarraga, Sofia
A1 Hernandez, Domingo
A1 Pascual, Julio
K1 Betacoronavirus
K1 COVID-19
K1 Coronavirus Infections
K1 Gastrointestinal Diseases
K1 Hospital Mortality
AB Coronavirus infectious disease 2019 (COVID-19) pandemic has posed at risk the kidney transplant (KT) population. We describe clinical pictures, risk factors for death, and chances to recovery in a large cohort of KT recipients with COVID-19. Inclusion in a Spanish prospectively filled registry was allowed for KT cases with confirmed COVID-19. Outcomes were assessed as in-hospital mortality or recovery. The study population comprised of 414 patients. Fever, respiratory symptoms, and dyspnea were the most frequent COVID-19-related symptoms, and 81.4% of them had pneumonia. More than one-third of patients showed digestive symptoms at diagnosis, combinations of nausea, vomiting, and diarrhea. Most patients were hospitalized, 12.1% in intensive care units, and 17.6% needed ventilator support. Treatment for COVID-19 included frequently hydroxychloroquine, azithromycin, high-dose steroids, lopinavir/ritonavir, and tocilizumab. After a mean follow-up of 44 days, the fatality rate was 26.3%. Pneumonia without gastrointestinal symptoms was associated with a 36.3% mortality (respiratory phenotype), and gastrointestinal symptoms without pneumonia with a 5.3% mortality (gastrointestinal phenotype). The mixed pneumonia and gastrointestinal phenotype showed an intermediate mortality of 19.5% (mixed phenotype). Multivariate Cox regression analysis showed that age and pneumonia were independently associated with death, whereas the gastrointestinal phenotype was associated with recovery. COVID-19 is frequent among the KT population. Advanced age and pneumonia are the main clinical features associated with a high-mortality rate. Gastrointestinal disease is associated with a more benign course and lower mortality.
PB Lippincott Williams & Wilkins
YR 2020
FD 2020-07-12
LK http://hdl.handle.net/10668/16112
UL http://hdl.handle.net/10668/16112
LA en
NO Crespo M, Mazuecos A, Rodrigo E, Gavela E, Villanego F, Sánchez-Alvarez E, et al. Respiratory and Gastrointestinal COVID-19 Phenotypes in Kidney Transplant Recipients. Transplantation. 2020 Nov;104(11):2225-2233
DS RISalud
RD Jul 17, 2025