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Letter to the Editor

COVID-19: A One-center Experience in Paris

Chavarot, Nathalie MD1; Fournier, Catherine RN1; Burger, Carole MD1; Amrouche, Lucile MD, PhD1; Legendre, Christophe MD1

Author Information
doi: 10.1097/TXD.0000000000001066
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At Necker hospital in Paris, we currently follow-up 2100 kidney transplant recipients who attend regularly our clinics at least once a year.

Out of these 2100 patients, 1936 (92%) have an accurate email address. To get information about our cohort during the coronavirus disease 2019 (COVID-19) pandemic, we sent a questionnaire to these 1936 patients, taking into account the period of time between April 4, 2020, and May 12, 2020. We got a correctly filled out questionnaire in 1497 patients (77.3%) but no answer in 440 cases (22%). In parallel, we received information from 80 patients who were diagnosed severe acute respiratory syndrome coronavirus 2 infection (54 of them without answer to the questionnaire and 26 who did answer).

Overall, out of the 1551 cases in whom we got data, only 161 patients (10.4%) had been tested for COVID-19 infection (defined as the presence of a positive severe acute respiratory syndrome coronavirus 2 on reverse transcriptase-polymerase chain reaction testing performed on nasopharyngeal swab) of whom 80 were tested positive (49.7%). In these 80 infected patients, clinical symptoms were reported as in Figure 1A. Seventeen patients (21.3%) died from pneumonia in intensive care unit. Overall, 838 patients (54%) of the cohort had no symptom, while clinical symptoms were present in 46% (Figure 1B), but the majority of these patients were not tested due to insufficient availability at that time. Notably, 32 nontested patients experienced anosmia and/or ageusia (2.1%). As these symptoms are particularly specific for COVID-19, prevalence of COVID-19 infection in our cohort could be estimated between 5.2% and 7.2%.

Clinical symptoms reported in kidney transplant recipients followed at Necker hospital. Clinical symptoms in (A) proved coronavirus disease 2019 (COVID-19) patients (n = 80) and (B) all the cohort (n = 1551).

Demographic characteristics of the proved COVID-19 population were not different from the whole population. Median age was 59 y (24–88 y), with a majority of men (68%) and 31% of African-Europeans. Infection occurred after a median time of 8.8 y (2.5 mo to 31 y) after transplantation.

These data are just giving a snapshot analysis of a large cohort of kidney transplant recipients followed at the same center in Paris. There are, of course, some biases. Many patients were not tested even though they had symptoms evoking COVID-19 leading to underestimate COVID-19 prevalence.

Infected patients developed infection mainly late after transplantation. Overall, the mortality rate was not very different from the one reported in the general population as was the mortality rate in patients with pulmonary involvement that required transfer to intensive care unit.

These data are, therefore, somewhat reassuring to decide to stop or not an active transplant program.

Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.