Outcomes of COVID‐19 in hospitalized solid organ transplant recipients compared to a matched cohort of non‐transplant patients at a national healthcare system in the United States

Abstract

Data describing outcomes of solid organ transplant (SOT) recipients with coronavirus disease 2019 (COVID‐19) are variable, and the association between SOT status and mortality remains unclear. In this study, we compare clinical outcomes of SOT recipients hospitalized with COVID‐19 between March 10, and September 1, 2020, to a matched cohort of non‐SOT recipients at a national healthcare system in the United States (US). From a population of 43 461 hospitalized COVID‐19‐positive patients, we created a coarsened exact matched cohort of 4035 patients including 128 SOT recipients and 3907 weighted matched non‐SOT controls. Multiple logistic regression was used to evaluate association between SOT status and clinical outcomes. Among the 4035 patients, median age was 60 years, 61.7% were male, 21.9% were Black/African American, and 50.8% identified as Hispanic/Latino ethnicity. Patients with a history of SOT were more likely to die within the study period when compared to matched non‐SOT recipients (21.9% and 14.9%, respectively; odds ratio [OR] 1.93; 95% confidence interval [CI]: 1.18–3.15). Moreover, SOT status was associated with increased odds of receiving invasive mechanical ventilation (OR [95% CI]: 2.34 [1.51–3.65]), developing acute kidney injury (OR [95% CI]: 2.41 [1.59–3.65]), and receiving vasopressor support during hospitalization (OR [95% CI]: 2.14 [1.31–3.48]).

COVID-19 in hospitalized lung and non-lung solid organ transplant recipients: A comparative analysis from a multicenter study

“…Solid organ transplant recipients (SOTR) are at risk for poor outcomes from coronavirus disease 2019 (COVID‐19) due to the frequent medical comorbidities and the potential impact of immunosuppression 1,2 . Lung transplant recipients (LTR) with COVID‐19 are unique among SOTR because severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) directly infects the allograft.…”

Modification in induction immunosuppression regimens to safely perform kidney transplants amid the COVID‐19 pandemic: A single‐center retrospective study

“…1 SOT recipients were found to have higher mortality and were more likely to require mechanical ventilation, vasopressor support, and develop acute kidney injury when compared to their non-SOT counterparts. 2,3 Mortality in SOT recipients hospitalized for COVID-19 can be up to 20%. 4 Due to these concerns, there was a 51.1% reduction in overall deceased donor transplantation in the USA since the COVID-19 outbreak.…”

Effects of immunosuppressive therapy reduction and early post-infection graft function in kidney transplant recipients with COVID-19

“…[1] Kidney transplant (KT) recipients is a subset of the population at high risk of severe COVID-19 relate consequences due to comorbidities, consequences of chronic kidney disease (CKD) and the burden of immunosuppressive therapy (IST), which in some subjects include also therapies administered before kidney transplantation to treat glomerulonephritis or underlying autoimmune diseases. [2] Data collected so far reported that transplant recipients were at higher risk of morbidity and mortality compared to the general population [3,4]. Despite the great emphasis on IST reduction to face the potentially lethal consequences of COVID-19, no confirming data supports its beneficial effect in terms of survival or clinical and laboratory manifestations.…”

“…Data collected so far reported that transplant recipients were at higher risk of morbidity and mortality compared to the general population [3,4]. Despite the great emphasis on IST reduction to face the potentially lethal consequences of COVID-19, no confirming data supports its beneficial effect in terms of survival or clinical and laboratory manifestations.…”