ENCOURAGING OUTCOMES OF SOLID ORGAN RECIPIENTS WITH COVID-19

Introduction: 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 Methods: Seven transplanted patients (two liver, three kidney, 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 Transplanted patients admitted to the ICU were compared to immunocompetent patients admitted to the ICU (n=19) Results: 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 after admission Weaning could be initiated in these patients after 16 and 19 days of mechanical ventilation, respectively One kidney and the lung transplant recipients were required to be intubated after ten and 15 days, respectively This kidney recipient was discharged in good health after 17 days Thus, only the lung transplant recipient is on mechanical ventilation Immunosuppression was adapted in five patients, but continued in all patients Target trough levels were evaluated regularly and were within range during hospital stay No graft loss or death was documented Compared to non-transplanted patients the inflammatory response was attenuated in transplanted patients, which was proven by decreased IL-6 and LDH blood values Conclusion: 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