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The editorial by Gross and McDougall highlights the innovative roles that pharmacists have taken on during the COVID-19 pandemic. 1 We aim to share our unique experience of multidisciplinary collaboration and adaptation of pharmacy practice within one of the nation's largest solid organ transplant (SOT) programs during the COVID-19 era.Recognizing the need to mitigate virus transmission, many team members, including our pharmacist, transitioned to working remotely. Following this change, our team swiftly initiated virtual rounding twice daily to improve communication between team members working onsite and remotely; multidisciplinary patient care discussions and team unity were preserved while maintaining social distance.During these virtual rounds, our pharmacist effectively made medication recommendations in order to ensure timely updates to patient care needs that required urgent intervention. This allowed our pharmacist and transplant coordinators to more efficiently work with the nurses and support staff onsite to schedule virtual patient education sessions.The COVID19 pandemic also required innovative means of continuing communication with our patients. SOT patients require thorough education on posttransplant medications and lifestyle choices.Our team transitioned these educational sessions to telemedicine education sessions. Meetings were arranged for the patients through institution owned iPads and caregivers could join the videoconference remotely. Before leaving the hospital, each of our patients received several hours of education with our pharmacist to assist their learning of medications, during which multiple teaching methods and tools were utilized. This communication method was also utilized for pretransplant patients when evaluating prior-to-admission medications and for readmitted patients to reinforce education. Several patients whose primary language was not English were also able to participate through multiprovider visits with simultaneous video interpretation. Other key members of our team including nurse practitioners transplant coordinators, and dieticians were able to learn from our pioneering experience and use this technology to safely and effectively communicate with our patients.SOT is a medical discipline that relies heavily on the collaboration of the interdisciplinary team. To maintain safety of our patients and team during the COVID-19 pandemic, we demonstrated ability to work together effectively in adapted roles. Through our innovative communication strategies, we have maintained exemplary patient care and outcomes. We will carry the lessons we learned through these challenges beyond the pandemic and continue to use them to ensure safe delivery of care.

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On February 26, 2020, the first case of community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States (US) was confirmed. 1 SARS-CoV-2 causes coronavirus disease 2019 (COVID-19), and on March 11, the World Health Organization declared COVID-19 a global pandemic. By May 27, 2020, SARS-CoV-2 had infected over 1.6 million people in the United States, resulting in over 100 000 deaths. 2 The ongoing pandemic has presented a challenging predicament for organ transplantation programs. The combination of a protracted asymptomatic incubation period of SARS-CoV-2 and the lack of capacity for rapid testing of potential donors to avoid transmission of SARS-CoV-2 were challenges to transplant programs. 3 Further, the effects of SARS-CoV-2 in highly immunosuppressed patients in the early post-transplant period are currently unclear. Nonetheless, it has been assumed that any significant viral infection in this patient cohort would be detrimental, which has been demonstrated in early reports. 4 In addition, cardiovascular disease has emerged as a risk factor for mortality with COVID-19. 5 Indeed, the number of patients inactivated on the heart transplant waitlist more than doubled between the weeks of March 8 and

Background:The COVID-19 pandemic has caused significant morbidity and mortality in solid organ transplant (SOT) recipients. However, it remains unclear whether the risk factor for SOT patients is the immunosuppression inherent to transplantation versus patient comorbidities. Methods:We reviewed outcomes in a cohort of SOT (n = 129) and non-SOT (NSOT) patients (n = 708) admitted to the University of California, Los Angeles for COVID-19 infection. Data analyses utilized multivariate logistic regression to evaluate the impact of patient demographics, comorbidities, and transplant status on outcomes. SOT patients were analyzed by kidney SOT (KSOT) versus nonkidney SOT (NKSOT) groups.Results: SOT and NSOT patients with COVID-19 infection differed in terms of patient age, ethnicity, and comorbidities. NKSOT patients were the most likely to experience death, with a mortality rate of 16.2% compared with 1.8% for KSOT and 8.3% for NSOT patients (p = .013). Multivariable analysis of hospitalized patients revealed that patient age (odds ratio [OR] 2.79, p = .001) and neurologic condition (OR 2.66, p < .001) were significantly associated with mortality. Analysis of ICU patients revealed a 2.98-fold increased odds of death in NKSOT compared with NSOT patients (p = .013). Conclusions:This study demonstrates the importance of transplant status in predicting adverse clinical outcomes in patients hospitalized or admitted to the ICU with COVID-19, especially for NKSOT patients. Transplant status and comorbidities, including age, could be used to risk stratify patients with COVID-19. This data suggests that immunosuppression contributes to COVID-19 disease severity and mortality and may have implications for managing immunosuppression, especially for critically ill patients admitted to the ICU.