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Volume 27, Number 2—February 2021
Dispatch

SARS-CoV-2 Infections among Recent Organ Recipients, March–May 2020, United States

Jefferson M. JonesComments to Author , Ian Kracalik, Meenakshi M. Rana, Ann Nguyen, Brian C. Keller, Aaron Mishkin, Charles Hoopes, Thomas Kaleekal, Abhinav Humar, Juan Vilaro, Gene Im, Lou Smith, April Justice, Collette Leaumont, Stephen Lindstrom, Brett Whitaker, Ricardo M. La Hoz, Marian G. Michaels, David Klassen, Wendi Kuhnert, and Sridhar V. Basavaraju
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.M. Jones, I. Kracalik, C. Leaumont, S. Lindstrom, B. Whitaker, W. Kuhnert, S.V. Basavaraju); Icahn School of Medicine at Mount Sinai, New York, New York, USA (M.M. Rana, G. Im); University of Chicago, Chicago, Illinois, USA (A. Nguyen); The Ohio State University College of Medicine, Columbus, Ohio, USA (B.C. Keller); Temple University, Philadelphia, Pennsylvania, USA (A. Mishkin); University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA (C. Hoopes); Robert Wood Johnson University, New Brunswick, New Jersey, USA (T. Kaleekal); University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (A. Humar, M.G. Michaels); University of Florida College of Medicine, Gainesville, Florida, USA (J. Vilaro); New York State Department of Health, Albany, New York, USA (L. Smith); Ohio Department of Health, Columbus (A. Justice); University of Texas Southwestern Medical Center, Dallas, Texas, USA (R.M. La Hoz); United Network of Organ Sharing, Richmond, Virginia, USA (D. Klassen)

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Table 2

Epidemiologic and clinical characteristics of index recipients associated with SARS-CoV-2 transmission in recipients of solid-organ transplants, United States, March–May 2020*

Index recipient Donor Organ Symptoms No. days from transplant to symptom onset Exposure to persons with COVID-19 No. days in hospital† No. days in ICU‡ No. days intubated‡ COVID-19 treatment Immunosuppressive medications, induction Immunosuppressive medications, maintenance Patient status
A
 A
 Bilateral lungs
 Fever, respiratory failure, diaphoresis, atrial fibrillation, shock, acute kidney failure
 6
 Confirmed COVID-19 among HCW contacts, potential nosocomial transmission
 109
 35
 41
 Hydroxychloroquine, azithromycin
 Basiliximab, methylprednisolone
 Mycophenolate, tacrolimus, prednisone
 Alive
B
 B
 Single lung
 Fever, nasal congestion
 14
 Confirmed COVID-19 among HCW contacts
 31
 None
 None
 Hydroxychloroquine
 Basiliximab, methylprednisolone
 Mycophenolate, tacrolimus, prednisone
 Alive
C
 C
 Liver
 Altered mental status, fever, respiratory failure
 9
 Confirmed COVID-19 among household contacts
 79
 66
 64
 Convalescent plasma
 Basiliximab
 Everolimus, prednisone
 Dead
D
 D
 Liver
 Cough
 7
 Suspected nosocomial transmission at transplant center
 49
 19
 19
 Hydroxychloroquine, azithromycin
 Methylprednisolone
 Tacrolimus, mycophenolate mofetil, prednisone
 Dead
E
 E
 Bilateral lungs
 None
 Asymptomatic
 Confirmed COVID-19 among HCW contacts
 17
 4
 2
 Chloroquine
 Basiliximab, methylprednisolone, mycophenolate mofetil
 Tacrolimus, mycophenolate mofetil, prednisone
 Alive
F
 F
 Single lung
 Fever, dyspnea, wheezing
 7
 Suspected nosocomial transmission at transplant center
 14
 14
 9
 Remdesivir, azithromycin, intravenous immunoglobulin
 Basiliximab
 Tacrolimus, mycophenolate mofetil, prednisone
 Dead
G
 G
 Heart and single kidney
 Tachycardia, respiratory failure
 81
 Confirmed COVID-19 among household contacts
 10
 9
 7
 Hydroxychloroquine, azithromycin
 Basiliximab, methylprednisolone
 Tacrolimus, mycophenolate mofetil, prednisone
 Alive
H H Heart Dyspnea, fever, diarrhea 9 Suspected nosocomial transmission at transplant center 84 77 9 Remdesivir, azithromycin, tocilizumab Basiliximab, methylprednisolone, mycophenolate mofetil Tacrolimus, mycophenolate mofetil, methylprednisolone Alive

*For all recipients, SARS-COV-2 test was by nasopharyngeal swab. COVID-19, coronavirus disease; HCW, healthcare worker; ICU, intensive care unit; SARS-COV-2, severe acute respiratory syndrome coronavirus 2.
†If patient never discharged since organ transplantation, number of days hospitalized since organ transplantation. If patient discharged and re-admitted, number of days hospitalized since most recent admission.
‡For patients C, D, and F, day of death is considered last day of hospitalization, day in ICU, or day intubated.

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Page created: December 10, 2020
Page updated: January 24, 2021
Page reviewed: January 24, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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