Microorganisms (Jun 2020)
Calcineurin Inhibitor-Based Immunosuppression and COVID-19: Results from a Multidisciplinary Cohort of Patients in Northern Italy
- Lorenzo Cavagna,
- Elena Seminari,
- Giovanni Zanframundo,
- Marilena Gregorini,
- Angela Di Matteo,
- Teresa Rampino,
- Carlomaurizio Montecucco,
- Stefano Pelenghi,
- Barbara Cattadori,
- Eleonora Francesca Pattonieri,
- Patrizio Vitulo,
- Alessandro Bertani,
- Gianluca Sambataro,
- Carlo Vancheri,
- Alessandro Biglia,
- Emanuele Bozzalla-Cassione,
- Valentina Bonetto,
- Maria Cristina Monti,
- Elena Ticozzelli,
- Annalisa Turco,
- Tiberio Oggionni,
- Angelo Corsico,
- Francesco Bertuccio,
- Valentina Zuccaro,
- Veronica Codullo,
- Monica Morosini,
- Carlo Marena,
- Massimiliano Gnecchi,
- Carlo Pellegrini,
- Federica Meloni
Affiliations
- Lorenzo Cavagna
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Elena Seminari
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy
- Giovanni Zanframundo
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Marilena Gregorini
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Angela Di Matteo
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy
- Teresa Rampino
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Carlomaurizio Montecucco
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Stefano Pelenghi
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Barbara Cattadori
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Eleonora Francesca Pattonieri
- Nephrology, Dialysis and Transplantation Unit, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Patrizio Vitulo
- Pulmonology Unit, IRCCS Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (ISMETT), 90100 Palermo, Italy
- Alessandro Bertani
- Thoracic Surgery Unit, IRCCS Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione (ISMETT), 90100 Palermo, Italy
- Gianluca Sambataro
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy
- Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Department of Clinical and Experimental Medicine, University of Catania, 95125 Catania, Italy
- Alessandro Biglia
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Emanuele Bozzalla-Cassione
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Valentina Bonetto
- Department of Biochemistry and Molecular Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
- Maria Cristina Monti
- Department of Public Health, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, 27100 Pavia, Italy
- Elena Ticozzelli
- General Surgery Unit, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Annalisa Turco
- Cardiology Department, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Tiberio Oggionni
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Angelo Corsico
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Francesco Bertuccio
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Valentina Zuccaro
- Infectious Diseases Clinic, University of Pavia and IRCCS Policlinico S. Matteo Foundation, 27100 Pavia, Italy
- Veronica Codullo
- Rheumatology Division, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Monica Morosini
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Carlo Marena
- SC Direzione Medica di Presidio, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Massimiliano Gnecchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Department of Medical Sciences and Infectious Disease, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Carlo Pellegrini
- Division of Cardiac Surgery, IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- Federica Meloni
- Department of Respiratory Diseases, University of Pavia and IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy
- DOI
- https://doi.org/10.3390/microorganisms8070977
- Journal volume & issue
-
Vol. 8,
no. 7
p. 977
Abstract
The role of immunosuppression in SARS-CoV-2-related disease (COVID-19) is a matter of debate. We here describe the course and the outcome of COVID-19 in a cohort of patients undergoing treatment with calcineurin inhibitors. In this monocentric cohort study, data were collected from the COVID-19 outbreak in Italy up to 28 April 2020. Patients were followed at our hospital for solid organ transplantation or systemic rheumatic disorders (RMDs) and were on calcineurin inhibitor (CNI)-based therapy. Selected patients were referred from the North of Italy. The aim of our study was to evaluate the clinical course of COVID-19 in this setting. We evaluated 385 consecutive patients (220 males, 57%; median age 61 years, IQR 48–69); 331 (86%) received solid organ transplantation and 54 (14%) had a RMD. CNIs were the only immunosuppressant administered in 47 patients (12%). We identified 14 (4%) COVID-19 patients, all transplanted, mainly presenting with fever (86%) and diarrhea (71%). Twelve patients were hospitalized and two of them died, both with severe comorbidities. No patients developed acute respiratory distress syndrome or infectious complications. The surviving 10 patients are now fully recovered. The clinical course of COVID-19 patients on CNIs is generally mild, and the risk of superinfection seems low.
Keywords
