Table 1.
Demographics and clinical presentation of pediatric solid organ transplant recipients with SARS‐CoV‐2 infection
| Pt | Sex | Tx age (years) | Ethnicity | Blood type | BMI | Organ | Donor type | Pertinent medical problems post‐transplant |
|---|---|---|---|---|---|---|---|---|
| 1 | M | 0.4 | Hispanic | O+ | 20.2 | Heart | Deceased | Shone's syndrome |
| 2 | M | 4 | White | O+ | 20.7 | Heart | Deceased | Atherosclerotic disease, CVA, GERD, asthma |
| 3 | M | 0.8 | Hispanic | A+ | 21.8 | Heart | Deceased | Cardiomyopathy, AKI, seizures |
| 4 | M | 0.5 | Hispanic | O+ | 17.4 | Heart | Deceased | Prematurity, chromosome 15q duplication, asthma |
| 5 | M | 17 | White | A+ | 25.1 | Heart | Deceased | CVA, kidney disease |
| 6 | F | 13 | Hispanic | A+ | 30.7 | Heart | Deceased | Restrictive cardiomyopathy, pulmonary HTN |
| 7 | F | 10 | Hispanic | O+ | 33.1 | Kidney | Living | Reflux nephropathy, DM, asthma, CVA, pancreatitis, migraines, hyponatremia |
| 8 | F | 18 | Hispanic | A+ | 22.2 | Kidney | Deceased | Loss first transplant acute rejection, chronic peritoneal dialysis, ADHD, seizure disorder, bx reveals mod ACR |
| 9 | F | 15 | Hispanic | AB+ | 38.8 | Kidney | Deceased | HTN, pulmonary edema, mild tricuspid and pulmonary regurgitation |
| 10 | M | 17 | Hispanic | A+ | 32.5 | Kidney | Deceased | Sarcoidosis, UTIs |
| 11 | M | 13 | AA | O+ | 21.4 | Kidney | Deceased | IgA nephropathy, HTN, DM, hypothyroidism |
| 12 | M | 12 | Hispanic | O+ | 29.3 | Kidney | Deceased | Cystic dysplasia, HTN |
| 13 | M | 14 | AA | O+ | 19.8 | Kidney | Deceased | ACR/AMR, paralysis, neurogenic bladder |
| 14 | M | 6 | Hispanic | O+ | 20.8 | Kidney | Deceased | CMV, C diff, hepatoblastoma |
| 15 | M | 13 | Hispanic | O+ | 33.3 | Liver | Deceased, Whole | Hepatic adenomatosis, insulin resistance |
| 16 | F | 8 | White | O− | 25.5 | Liver | Deceased, Whole | Biliary atresia, failed Kasai |
| 17 | F | 1.1 | White | A+ | 24.4 | Liver | Deceased, Whole | Hepatoblastoma, HTN, CKD |
| 18 | F | 0.6 | Hispanic | O+ | 19.4 | Liver | Deceased, Whole | Failure to thrive |
| 19 | F | 13 | Hispanic | O+ | 33.5 | Liver | Deceased, Whole | Ellis‐van Creveld syndrome, HTN, asthma, hypothyroidism |
| 20 | M | 1.9 | White | O+ | 19.1 | Liver | Deceased, Whole | Hepatoblastoma, adrenal insufficiency, RTA, chemo‐induced anemia/thrombocytopenia |
| 21 | F | 3 | Hispanic | O+ | 17.7 | Liver | Deceased, Whole | None |
| 22 | M | 1.8 | Hispanic | A+ | 17.8 | Liver | Deceased, Whole | Seizure disorder, chronic lung disease, asthma, global development delay |
| 23 | F | 4 | Hispanic | O+ | 19.5 | Liver | Deceased, Whole | None |
| 24 | M | 0.8 | Hispanic | A+ | 18.8 | Liver | Deceased, Whole | Adrenal insufficiency, DM |
| 25 | M | 8 | Hispanic | O+ | 19.9 | Lung | Deceased | CF, chronic sinusitis, DIOS, osteoporosis |
| 26 | M | 9 | Hispanic | O− | 23.5 | Lung | Deceased | Bone marrow tx, seizures, HTN, asthma |
| Time from Tx to Infection (days) | Presenting symptoms | Exposure | Hospitalized | CXR/CT findings |
|---|---|---|---|---|
| 6129 | Anosmia | Family member | No | N/O |
| 1182 | Cough, rhinorrhea | Family member | No | N/O |
| 1874 | Fever | Family member | Yes (trach care) | N/O |
| 410 | Fever | Family member | Yes | Yes (normal) |
| 1114 | Cough, fever | Family member | No | N/O |
| 2879 | Cough, dry throat | Community‐acquired | No | N/O |
| 4868 | Anosmia, cough, fever, rhinorrhea | Community‐acquired | Yes (migraine/hyponatremia) | N/O |
| 12 | Cough | Family member | Yes (post‐transplant) | Yes (multifocal infiltrates) |
| 1256 | Cough, fever | Hospital exposure | No | Yes (normal) |
| 436 | None | Family member | No | N/O |
| 2677 | Diarrhea | Community‐acquired | No | Yes (normal) |
| 2542 | None | Community‐acquired | No | N/O |
| 1882 | None | Community‐acquired | No | N/O |
| 119 | None | Home health RN | No | Yes (normal) |
| 1236 | Chest pain, cough | Community‐acquired | Yes | Yes (multifocal infiltrates) |
| 784 | Cough, dyspnea, sore throat | Community‐acquired | No | N/O |
| 4444 | Cough, diarrhea, fever | Family member | Yes | Yes (normal) |
| 1910 | Fever | Community‐acquired | Yes | N/O |
| 958 | Cough | Family member | No | N/O |
| 1138 | Cough | Family member | No | N/O |
| 560 | Fever | Community‐acquired | No | N/O |
| 814 | Rhinorrhea | Community‐acquired | Yes | N/O |
| 1659 | None | Family member | No | N/O |
| 6574 | Chest pain, fever, headache | Family member | No | N/O |
| 3127 | None | Community‐acquired | No | Yes (normal) |
| 933 | Cough, sore throat | Family member | No | N/O |
| Basic labs | Inflammation/Hypercoagulable evaluation | New O2 therapy | Maintenance immunosuppression | Immunosuppression change | COVID‐19 therapy |
|---|---|---|---|---|---|
| N/O | N/O | No | TAC, Rapa, Pred | No | No |
| Wnl | N/O | No | TAC, Rapa | No | No |
| Wnl | N/O | No | TAC, MMF | No | No |
| Wnl | Inc CRP, D‐dimer | No | TAC, MMF | No | No |
| Dec WBC | N/O | No | Rapa, Pred, cyclosporine | No | No |
| Wnl | N/O | No | TAC, azathioprine | No | No |
| Wnl | Inc CRP, fibrinogen, D‐dimer | No | TAC, azathioprine | No | Enoxaparin sulfate |
| Dec WBC, Hgb, Hct | Inc CRP, ferritin, fibrinogen, D‐dimer | No | TAC, MMF, ATG | Yes (reduction) | No |
| Dec Hgb, Hct | Inc CRP, fibrinogen, D‐dimer | No | TAC, MMF | No | No |
| Wnl | Wnl | No | TAC, Pred | No | No |
| N/O | N/O | No | TAC, MMF, Pred | No | No |
| Dec WBC | N/O | No | TAC, MMF | No | No |
| Dec Hgb, Hct | Inc ferritin | No | TAC, MMF, Pred | No | No |
| N/O | N/O | No | TAC, MMF, Pred | No | No |
| Dec WBC | Inc CRP, fibrinogen, D‐dimer | No | TAC, Rapa | Yes (reduction) | Azm |
| Wnl | N/O | No | TAC | No | No |
| Wnl | Wnl | No | TAC, MMF, Pred | No | Azm, HCQ |
| Wnl | Inc CRP | No | TAC, MMF | No | Azm |
| Wnl | N/O | No | TAC | No | Azm |
| Dec WBC | N/O | No | TAC | No | No |
| Wnl | N/O | No | TAC | No | No |
| Dec Hgb, Hct | Wnl | No | TAC, Pred | No | No |
| Wnl | N/O | No | TAC, Rapa, Pred | No | No |
| Dec WBC | Wnl | No | TAC, Pred | No | No |
| Wnl | Wnl | No | TAC, MMF, Pred | No | No |
| Wnl | N/O | No | TAC, MMF, Pred | No | No |
| Bacterial co‐infection | Antimicrobial agents | Disposition |
|---|---|---|
| No | No | Home |
| No | No | Home |
| No | Levofloxacin, nitrofurantoin | Home |
| No | Ceftriaxone | Home |
| No | No | Home |
| No | No | Home |
| No | Ceftriaxone, linezolid | Home |
| No | No | Hospital (unrelated) |
| No | No | Home |
| No | No | Home |
| No | No | Home |
| No | No | Home |
| Yes (GBS UTI) | No | Home |
| No | No | Home |
| No | Azm, ceftriaxone | Home |
| No | No | Home |
| No | Azm | Home |
| No | Azm | Home |
| No | Azm | Home |
| No | No | Home |
| No | No | Home |
| No | No | Home |
| No | No | Home |
| No | No | Home |
| No | Azm ppx | Home |
| No | None | Home |
Abbreviations: ADHD, attention‐deficit/hyperactivity disorder; AKI, acute kidney injury; AMR, antibody‐mediated rejection; Azm, azithromycin; CF, cystic fibrosis; CKD, chronic kidney disease; CMV, cytomegalovirus; CVA, cerebrovascular accident; DIOS, distal intestinal obstructive syndrome; DM, diabetes mellitus; ESRD, end‐stage renal disease; GERD, gastroesophageal reflux disease; N/O, not obtained; PIGN, post‐infectious glomerulonephritis; Ppx, prophylaxis; Pred, prednisone; Rapa, rapamune/sirolimus; RN, registered nurse; RTA, renal tubular acidosis.