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COVID-19 is a pandemic with a rapidly increasing incidence of infections and deaths. Many pharmacologic therapies are being used or considered for treatment. Given the rapidity of emerging literature, IDSA felt the need to develop living, frequently updated evidence-based guidelines to support patients, clinicians and other health-care professionals in their decisions about treatment and management of patients with COVID-19 infection. Summarized here are the recommendations with comments...
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Among 495 immunocompromised patients positive for SARS-CoV-2, PCR cycle thresholds remained <33 beyond 20 days more frequently in patients with hematologic malignancies, particularly those receiving B-cell depleting or BTKi therapy, compared to those with solid organ malignancy (26% vs 5%).
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Lung transplantation is one of the only options for patients with severe coronavirus disease 2019 (COVID-19)–associated lung injury (CALI). Studies on patients who received a lung transplant for CALI have, to date, not looked at the infectious outcomes.After institutional review board approval, a retrospective case-control cohort study, matched 1:1, collected data on patients who underwent lung transplantation for CALI (case) and for non–COVID-19 end-stage lung disease (control) between 1...
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Abstract Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) is a safe and effective treatment for COVID-19 in immunocompromised (IC) patients. IC patients have a higher risk of persistent infection, severe disease, and death from COVID-19. Despite the continued clinical use of CCP to treat IC patients, the optimal dose, frequency/schedule, and duration of CCP treatment has yet to be determined, and related best practices guidelines are lacking. A group of individuals...
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Severely immunocompromised patients are at risk for prolonged or relapsed COVID-19 leading to increased morbidity and mortality. We aimed to evaluate efficacy and safety of combination treatment in immunocompromised COVID-19 patients.We included all immunocompromised patients with prolonged/relapsed COVID-19 treated with combination therapy with two antivirals (remdesivir plus nirmatrelvir/ritonavir, or molnupiravir in case of renal failure) plus, if available, anti-spike monoclonal...
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Patients who are immunocompromised have increased risk for morbidity and mortality associated with coronavirus disease 2019 (COVID-19) because they less frequently mount antibody responses to vaccines. Although neutralizing anti-spike monoclonal-antibody treatment has been widely used to treat COVID-19, evolutions of SARS-CoV-2 have been associated with monoclonal antibody-resistant SARS-CoV-2 variants and greater virulence and transmissibility of SARS-CoV-2. Thus, the therapeutic use of...
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Background Decisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test-positive (NAT+) donors must balance risk of donor-derived transmission events (DDTE) with the scarcity of available organs. Methods Organ Procurement and Transplantation Network (OPTN) data were used to compare organ utilization and recipient outcomes between SARS-CoV-2 NAT+ and NAT– donors. NAT+ was defined by either a positive upper or lower respiratory tract (LRT)...
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CDC reviewed COVID-19 rebound studies among patients who
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Background Transplant and hematologic malignancy patients have high Coronavirus disease 2019 (COVID-19) mortality and impaired vaccination responses. Omicron variant evades several monoclonal antibodies previously used in immunocompromised patients. Polyclonal COVID-19 convalescent plasma (CCP) may provide broader neutralizing capacity against new variants at high titers. Vaccination increases severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) titer in convalescent donors. Methods...
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Information regarding COVID-19 continues to change rapidly. This document will be updated with new information whenever possible. Please contact your transplant center with specific questions or concerns. Human coronaviruses are common viruses that cause the common cold, and do not usually cause serious symptoms. A novel coronavirus named SARS-CoV-2 causes the disease called Coronavirus disease 2019 (COVID-19). This coronavirus appeared in December 2019 and quickly spread all over the...
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The COVID-19 pandemic has had a significant impact on donor evaluation and organ procurement.1 As the virus entrenches itself, the risk of donor-derived infection must be balanced with the risk of morbidity and mortality while remaining on the transplant waitlist. Decisions to proceed with organ transplant locally must balance the existing capacity of the center, availability of testing for donors and candidates, and sufficient capacity to provide adequate occupational protection to recovery...
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