{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:35:46Z","timestamp":1784975746271,"version":"3.55.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["COV20\/00370"],"award-info":[{"award-number":["COV20\/00370"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["REIPI RD16\/0016"],"award-info":[{"award-number":["REIPI RD16\/0016"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["COV20\/00370; COV20\/00580"],"award-info":[{"award-number":["COV20\/00370; COV20\/00580"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["COV20\/00370; COV20\/00580"],"award-info":[{"award-number":["COV20\/00370; COV20\/00580"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011011","name":"Junta de Andaluc\u00eda","doi-asserted-by":"publisher","award":["C-0059-2018"],"award-info":[{"award-number":["C-0059-2018"]}],"id":[{"id":"10.13039\/501100011011","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of 210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and\/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193\/200 (96.5%), lopinavir\/ritonavir 91\/200 (45.5%), and tocilizumab 49\/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death: advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant period.<\/jats:p>","DOI":"10.1371\/journal.pone.0250796","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T17:31:13Z","timestamp":1619717473000},"page":"e0250796","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk factors for unfavorable outcome and impact of early post-transplant infection in solid organ recipients with COVID-19: A prospective multicenter cohort 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Actualizaci\u00f3n no 167 (21 de Julio de 2020). Enfermedad por el coronavirus (COVID-19)."},{"key":"pone.0250796.ref004","article-title":"COVID-19 in Spain: Transplantation in the midst of the pandemic","author":"B Dom\u00ednguez-Gil","year":"2020","journal-title":"American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons"},{"issue":"18","key":"pone.0250796.ref005","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"W Guan","year":"2020","journal-title":"N Engl J Med"},{"key":"pone.0250796.ref006","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","author":"N Chen","year":"2020","journal-title":"Lancet"},{"key":"pone.0250796.ref007","article-title":"Baseline Characteristics and Outcomes of 1591 Patients Infected with 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transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons"},{"key":"pone.0250796.ref022","article-title":"Prolonged SARS-CoV-2 shedding and mild course of COVID-19 in a patient after recent heart transplantation","author":"A Decker","year":"2020","journal-title":"Am J Transplant"},{"key":"pone.0250796.ref023","article-title":"Early COVID-19 infection after lung transplantation","author":"BC Keller","year":"2020","journal-title":"American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. United States"},{"key":"pone.0250796.ref024","article-title":"Viral shedding prolongation in a kidney transplant patient with COVID-19 pneumonia","author":"Z Man","year":"2020","journal-title":"American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons"},{"key":"pone.0250796.ref025","article-title":"Novel Corona Virus 2019 pneumonia in a kidney transplant recipient","author":"N Namazee","year":"2020","journal-title":"American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons"},{"key":"pone.0250796.ref026","article-title":"COVID-19, organ transplantation, and the nuances of immunomodulation: lessons learned and what comes next","author":"G Haidar","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pone.0250796.ref027","article-title":"Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pone.0250796.ref028","article-title":"A quick prediction tool for unfavourable outcome in COVID-19 inpatients: Development and internal validation","author":"S Salto-Alejandre","year":"2020","journal-title":"J Infect. 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Traspl"},{"key":"pone.0250796.ref034","article-title":"COVID-19 in solid organ transplant recipients: Initial report from the US epicenter","author":"MR Pereira","year":"2020","journal-title":"Am J Transplant"},{"key":"pone.0250796.ref035","article-title":"COVID-19 in solid organ transplant recipients: dynamics of disease progression and inflammatory markers in ICU and non-ICU admitted patients","author":"MB Roberts","year":"2020","journal-title":"Transpl Infect Dis"},{"key":"pone.0250796.ref036","article-title":"Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States","author":"Z Imam","year":"2020","journal-title":"J Intern Med"},{"key":"pone.0250796.ref037","article-title":"Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy","author":"F Ciceri","year":"2020","journal-title":"Clin Immunol"},{"key":"pone.0250796.ref038","article-title":"Characteristics and Outcomes of Coronavirus 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