Browsing by Author "Hemmersbach-Miller, Marion"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Item Open Access Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic.(American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2022-01) Heldman, Madeleine R; Kates, Olivia S; Safa, Kassem; Kotton, Camille N; Georgia, Sarah J; Steinbrink, Julie M; Alexander, Barbara D; Hemmersbach-Miller, Marion; Blumberg, Emily A; Multani, Ashrit; Haydel, Brandy; La Hoz, Ricardo M; Moni, Lisset; Condor, Yesabeli; Flores, Sandra; Munoz, Carlos G; Guitierrez, Juan; Diaz, Esther I; Diaz, Daniela; Vianna, Rodrigo; Guerra, Giselle; Loebe, Matthias; Rakita, Robert M; Malinis, Maricar; Azar, Marwan M; Hemmige, Vagish; McCort, Margaret E; Chaudhry, Zohra S; Singh, Pooja P; Hughes Kramer, Kailey; Velioglu, Arzu; Yabu, Julie M; Morillis, Jose A; Mehta, Sapna A; Tanna, Sajal D; Ison, Michael G; Derenge, Ariella C; van Duin, David; Maximin, Adrienne; Gilbert, Carlene; Goldman, Jason D; Lease, Erika D; Fisher, Cynthia E; Limaye, Ajit P; UW COVID-19 SOT Study TeamMortality among patients hospitalized for COVID-19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID-19, we compared 28-day mortality between early 2020 (March 1, 2020-June 19, 2020) and late 2020 (June 20, 2020-December 31, 2020). Multivariable logistic regression was used to assess comorbidity-adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (p < .001). Crude 28-day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46-0.98, p = .016). Between the early and late periods, the use of corticosteroids (≥6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%], p < .001 and 50/571 [8.8%] vs. 213/402 [52.2%], p < .001, respectively), and the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%], p < .001 and 73/571 [12.8%] vs. 5/402 [1.2%], p < .001, respectively). Mortality among SOTR hospitalized for COVID-19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study.Item Open Access Delayed mortality among solid organ transplant recipients hospitalized for COVID-19.(Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022-02) Heldman, Madeleine R; Kates, Olivia S; Safa, Kassem; Kotton, Camille N; Multani, Ashrit; Georgia, Sarah J; Steinbrink, Julie M; Alexander, Barbara D; Blumberg, Emily A; Haydel, Brandy; Hemmige, Vagish; Hemmersbach-Miller, Marion; La Hoz, Ricardo M; Moni, Lisset; Condor, Yesabeli; Flores, Sandra; Munoz, Carlos G; Guitierrez, Juan; Diaz, Esther I; Diaz, Daniela; Vianna, Rodrigo; Guerra, Giselle; Loebe, Matthias; Yabu, Julie M; Kramer, Kailey Hughes; Tanna, Sajal D; Ison, Michael G; Rakita, Robert M; Malinis, Maricar; Azar, Marwan M; McCort, Margaret E; Singh, Pooja P; Velioglu, Arzu; Mehta, Sapna A; van Duin, David; Goldman, Jason D; Lease, Erika D; Wald, Anna; Limaye, Ajit P; Fisher, Cynthia E; UW Covid-19 SOT Study TeamIntroduction
Most studies of solid organ transplant (SOT) recipients with COVID-19 focus on outcomes within one month of illness onset. Delayed mortality in SOT recipients hospitalized for COVID-19 has not been fully examined.Methods
We used data from a multicenter registry to calculate mortality by 90 days following initial SARS-CoV-2 detection in SOT recipients hospitalized for COVID-19 and developed multivariable Cox proportional-hazards models to compare risk factors for death by days 28 and 90.Results
Vital status at day 90 was available for 936 of 1117 (84%) SOT recipients hospitalized for COVID-19: 190 of 936 (20%) died by 28 days and an additional 56 of 246 deaths (23%) occurred between days 29 and 90. Factors associated with mortality by day 90 included: age > 65 years [aHR 1.8 (1.3-2.4), p =<0.001], lung transplant (vs. non-lung transplant) [aHR 1.5 (1.0-2.3), p=0.05], heart failure [aHR 1.9 (1.2-2.9), p=0.006], chronic lung disease [aHR 2.3 (1.5-3.6), p<0.001] and body mass index ≥ 30 kg/m 2 [aHR 1.5 (1.1-2.0), p=0.02]. These associations were similar for mortality by day 28. Compared to diagnosis during early 2020 (March 1-June 19, 2020), diagnosis during late 2020 (June 20-December 31, 2020) was associated with lower mortality by day 28 [aHR 0.7 (0.5-1.0, p=0.04] but not by day 90 [aHR 0.9 (0.7-1.3), p=0.61].Conclusions
In SOT recipients hospitalized for COVID-19, >20% of deaths occurred between 28 and 90 days following SARS-CoV-2 diagnosis. Future investigations should consider extending follow-up duration to 90 days for more complete mortality assessment.Item Open Access Disseminated Adenovirus Infection After Combined Liver-Kidney Transplantation(FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY, 2018-11-20) Hemmersbach-Miller, Marion; Bailey, Emily S; Kappus, Matthew; Prasad, Vinod K; Gray, Gregory C; Alspaugh, J AndrewItem Open Access Healthcare resource use among solid organ transplant recipients hospitalized with COVID-19.(Clinical transplantation, 2021-02) Heldman, Madeleine R; Kates, Olivia S; Haydel, Brandy M; Florman, Sander S; Rana, Meenakshi M; Chaudhry, Zohra S; Ramesh, Mayur S; Safa, Kassem; Kotton, Camille N; Blumberg, Emily A; Besharatian, Behdad D; Tanna, Sajal D; Ison, Michael G; Malinis, Maricar; Azar, Marwan M; Rakita, Robert M; Morillas, Jose A; Majeed, Aneela; Sait, Afrah S; Spaggiari, Mario; Hemmige, Vagish; Mehta, Sapna A; Neumann, Henry; Badami, Abbasali; Jeng, Amy; Goldman, Jason D; Lala, Anuradha; Hemmersbach-Miller, Marion; McCort, Margaret E; Bajrovic, Valida; Ortiz-Bautista, Carlos; Friedman-Moraco, Rachel; Sehgal, Sameep; Lease, Erika D; Limaye, Ajit P; Fisher, Cynthia EItem Open Access Transplant Drug Interactions and a Word of Caution for the HIV Provider. A Case Report.(Open forum infectious diseases, 2018-04-05) Hemmersbach-Miller, Marion; Berg, Carl L; Messina, Julia A; Wolfe, Cameron RElectronic medical record platforms fail to support provider alerts when a drug is discontinued. Protease inhibitors, often boosted by ritonavir or cobicistat, increase the serum concentration of calcineurin inhibitors. This case demonstrates acute liver transplant rejection in an HIV-positive recipient due to a failure to recognize the loss of protease inhibitor interaction with his immunosuppressive regimen.