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COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium

Cravedi et al., American Journal of Transplantation, doi:10.1111/ajt.16185
Jul 2020  
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Mortality -53% Improvement Relative Risk HCQ for COVID-19  Cravedi et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 144 patients in the USA Higher mortality with HCQ (not stat. sig., p=0.17) c19hcq.org Cravedi et al., American J. Transplant.., Jul 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Analysis of 144 hospitalized kidney transplant patients showing HCQ mortality HR 1.53, p = 0.17. Subject to confounding by indication.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely.
risk of death, 53.0% higher, RR 1.53, p = 0.17, treatment 36 of 101 (35.6%), control 10 of 43 (23.3%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cravedi et al., 10 Jul 2020, retrospective, USA, peer-reviewed, mean age 60.0, 25 authors, average treatment delay 6.0 days.
This PaperHCQAll
COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium
Paolo Cravedi, Suraj S Mothi, Yorg Azzi, Meredith Haverly, Samira S Farouk, María J Pérez-Sáez, Maria D Redondo-Pachón, Barbara Murphy, Sander Florman, Laura G Cyrino, Monica Grafals, Sandheep Venkataraman, Xingxing S Cheng, Aileen X Wang, Gianluigi Zaza, Andrea Ranghino, Lucrezia Furian, Joaquin Manrique, Umberto Maggiore, Ilaria Gandolfini, Nikhil Agrawal, Het Patel, Enver Akalin, Leonardo V Riella
American Journal of Transplantation, doi:10.1111/ajt.16185
Kidney transplant recipients may be at a high risk of developing critical coronavirus disease 2019 (COVID-19) illness due to chronic immunosuppression and comorbidities. We identified hospitalized adult kidney transplant recipients at 12 transplant centers in the United States, Italy, and Spain who tested positive for COVID-19. Clinical presentation, laboratory values, immunosuppression, and treatment strategies were reviewed, and predictors of poor clinical outcomes were determined through multivariable analyses. Among 9845 kidney transplant recipients across centers, 144 were hospitalized due to COVID-19 during the 9-week study period. Of the 144 patients, 66% were male with a mean age of 60 (±12) years, and 40% were Hispanic and 25% | 3141 CRAVEDI Et Al.
D I SCLOS U R E The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.
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Late treatment
is less effective
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