International Database on Organ Donation and Transplantation - COVID19
Concept and Hypotesis
Establishing treatment protocols in the current epidemic status of a novel disease is incompatible with awaiting for large multicentre retrospective studies that may be published in a later future. In order to provide evidence towards clinical decision making, transplant physicians need to be able to access a large database which enables them to compare outcomes using different strategies.
H1: In the current pandemic with the new SARS-CoV2 coronavirus, disease presentation and severity of the infection are higher in patients receiving SOT.
H2: Immunosuppressive treatment and management in SARS-CoV2 infected patients will influence the evolution and cure of the disease.
H3. A personalized decision support algorithm will enable to optimize outcomes at individual patient data.
The main objectives of this project are the development of a tool that helps in the management of immunosuppression and the treatment of COVID19 infection in SOT recipients.
To achieve this, the following objectives have been designed to be developed in stages and progressively:
1. Creation of an international database that includes all SOT recipient patients with COVID19 infection (confirmed or suspected);
2. Inclusion of different clinical and analytical data with recognized prognostic factor in the general population;
3. Inclusion of treatment data, including management of immunosuppression and clinical outcomes;
4. Development of a Decision Support Algorithm (DSA) that can assist the scientific community in updating their treatment management and immunosuppression protocols in this high-risk population.
Decision Support Algorithm (DSA)
The DSA to be developed aims at aiding clinicians in their decision regarding treatment alternatives at the individual level. In summary, the Algorithm will be developed and trained based on the already available data on the database, with focus on pre-admission (i.e. recipient demographics, transplant type) and at admission (i.e. symptoms and biochemical values) data to explore and predict outcomes. The DSA will be developed in two phases (see methdology).
Once trained, upon introduction of a new patient on the database, expected outcomes according to the different therapeutic approaches will be provided to clinicians (i.e. expected outcomes according to withdrawal of immunosuppression or administration of COVID-19 therapeutic alternatives). This information will provide clinicians with real-time personalized information, and hopefully will aid in clinical decision making.