TY - JOUR
T1 - Incidence and Outcomes of COVID-19 in Kidney and Liver Transplant Recipients With HIV
T2 - Report From the National HOPE in Action Consortium
AU - HOPE in Action Investigators
AU - Mehta, Sapna A.
AU - Rana, Meenakshi M.
AU - Motter, Jennifer D.
AU - Small, Catherine B.
AU - Pereira, Marcus R.
AU - Stosor, Valentina
AU - Elias, Nahel
AU - Haydel, Brandy
AU - Florman, Sander
AU - Odim, Jonah
AU - Morsheimer, Megan
AU - Robien, Mark
AU - Massie, Allan B.
AU - Brown, Diane
AU - Boyarsky, Brian J.
AU - Garonzik-Wang, Jacqueline
AU - Tobian, Aaron A.R.
AU - Werbel, William A.
AU - Segev, Dorry L.
AU - Durand, Christine M.
AU - Piquant, Dominique
AU - Lee, Dong Heun
AU - Edwards, Carolyn
AU - Wolfe, Cameron
AU - Link, Katherine
AU - Friedman-Moraco, Rachel
AU - Pearson, Thomas
AU - Mehta, Aneesh K.
AU - Marshall Lyon, G.
AU - Kitchens, William
AU - Huckaby, Jeryl
AU - Elbein, Rivka
AU - Roberson, April
AU - Ferry, Elizabeth
AU - Adebiyi, Oluwafisayo
AU - Adebiyi, Margaret
AU - Chen, Jeanne M.
AU - Thomas, Margret
AU - Gilbert, Alexander
AU - Coakley, Margaret
AU - Akhran, Aleya
AU - Timpone, Joseph
AU - Stucke, Alyssa
AU - Kusemiju, Oyinkansola
AU - Eby, Yolanda
AU - Fernandez, Reinaldo
AU - Kirby, Charles
AU - Miller, Jernelle
AU - Dunn, Ty
AU - Pruett, Timothy
N1 - Funding Information:
This work was supported by grant numbers 1R01AI120938 and U01AI134591 and U01AI138897 from the National Institute of Allergy and Infectious Diseases (NIAID). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health
Funding Information:
This work was supported by grant numbers 1R01AI120938 and U01AI134591 and U01AI138897 from the National Institute of Allergy and Infectious Diseases (NIAID). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.
Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Background. Transplant recipients with HIV may have worse outcomes with coronavirus disease 2019 (COVID-19) due to impaired T-cell function coupled with immunosuppressive drugs. Alternatively, immunosuppression might reduce inflammatory complications and/or antiretrovirals could be protective. Methods. Prospective reporting of all cases of SARS-CoV-2 infection was required within the HOPE in Action Multicenter Consortium, a cohort of kidney and liver transplant recipients with HIV who have received organs from donors with and without HIV at 32 transplant centers in the United States. Results. Between March 20, 2020 and September 25, 2020, there were 11 COVID-19 cases among 291 kidney and liver recipients with HIV (4%). In those with COVID-19, median age was 59 y, 10 were male, 8 were kidney recipients, and 5 had donors with HIV. A higher proportion of recipients with COVID-19 compared with the overall HOPE in the Action cohort were Hispanic (55% versus 12%) and received transplants in New York City (73% versus 34%, P < 0.05). Most (10/11, 91%) were hospitalized. High-level oxygen support was required in 7 and intensive care in 5; 1 participant opted for palliative care instead of transfer to the intensive care unit. HIV RNA was undetectable in all. Median absolute lymphocyte count was 0.3 × 103 cells/μL. Median CD4 pre–COVID-19 was 298 cells/μL, declining to <200 cells/μl in 6/7 with measurements on admission. Treatment included high-dose steroids (n = 6), tocilizumab (n = 3), remdesivir (n = 2), and convalescent plasma (n = 2). Four patients (36%) died. Conclusions. Within a national prospective cohort of kidney and liver transplant recipients with HIV, we report high mortality from COVID-19.
AB - Background. Transplant recipients with HIV may have worse outcomes with coronavirus disease 2019 (COVID-19) due to impaired T-cell function coupled with immunosuppressive drugs. Alternatively, immunosuppression might reduce inflammatory complications and/or antiretrovirals could be protective. Methods. Prospective reporting of all cases of SARS-CoV-2 infection was required within the HOPE in Action Multicenter Consortium, a cohort of kidney and liver transplant recipients with HIV who have received organs from donors with and without HIV at 32 transplant centers in the United States. Results. Between March 20, 2020 and September 25, 2020, there were 11 COVID-19 cases among 291 kidney and liver recipients with HIV (4%). In those with COVID-19, median age was 59 y, 10 were male, 8 were kidney recipients, and 5 had donors with HIV. A higher proportion of recipients with COVID-19 compared with the overall HOPE in the Action cohort were Hispanic (55% versus 12%) and received transplants in New York City (73% versus 34%, P < 0.05). Most (10/11, 91%) were hospitalized. High-level oxygen support was required in 7 and intensive care in 5; 1 participant opted for palliative care instead of transfer to the intensive care unit. HIV RNA was undetectable in all. Median absolute lymphocyte count was 0.3 × 103 cells/μL. Median CD4 pre–COVID-19 was 298 cells/μL, declining to <200 cells/μl in 6/7 with measurements on admission. Treatment included high-dose steroids (n = 6), tocilizumab (n = 3), remdesivir (n = 2), and convalescent plasma (n = 2). Four patients (36%) died. Conclusions. Within a national prospective cohort of kidney and liver transplant recipients with HIV, we report high mortality from COVID-19.
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U2 - 10.1097/TP.0000000000003527
DO - 10.1097/TP.0000000000003527
M3 - Article
C2 - 33165238
AN - SCOPUS:85099007821
SN - 0041-1337
VL - 105
SP - 216
EP - 224
JO - Transplantation
JF - Transplantation
IS - 1
ER -
