1. Clinical characteristics and outcomes of COVID-19 in solid organ transplant recipients: A cohort study.
- Author
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Chaudhry ZS, Williams JD, Vahia A, Fadel R, Parraga Acosta T, Prashar R, Shrivastava P, Khoury N, Pinto Corrales J, Williams C, Nagai S, Abouljoud M, Samaniego-Picota M, Abreu-Lanfranco O, Del Busto R, Ramesh MS, Patel A, and Alangaden GJ
- Subjects
- Aged, Comorbidity, Female, Graft Rejection epidemiology, Humans, Incidence, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Risk Factors, United States epidemiology, COVID-19 epidemiology, Graft Rejection prevention & control, Immunosuppression Therapy methods, Organ Transplantation, Pandemics, SARS-CoV-2, Transplant Recipients
- Abstract
Solid organ transplant recipients (SOTr) with coronavirus disease 2019 (COVID-19) are expected to have poorer outcomes compared to nontransplant patients because of immunosuppression and comorbidities. The clinical characteristics of 47 SOTr (38 kidneys and 9 nonkidney organs) were compared to 100 consecutive hospitalized nontransplant controls. Twelve of 47 SOTr managed as outpatients were subsequently excluded from the outcome analyses to avoid potential selection bias. Chronic kidney disease (89% vs 57% P = .0007), diabetes (66% vs 33% P = .0007), and hypertension (94% vs 72% P = .006) were more common in the 35 hospitalized SOTr compared to controls. Diarrhea (54% vs 17%, P < .0001) was more frequent in SOTr. Primary composite outcome (escalation to intensive care unit, mechanical ventilation, or in-hospital all-cause mortality) was comparable between SOTr and controls (40% vs 48%, odds ratio [OR] 0.72 confidence interval [CI] [0.33-1.58] P = .42), despite more comorbidities in SOTr. Acute kidney injury requiring renal replacement therapy occurred in 20% of SOTr compared to 4% of controls (OR 6 CI [1.64-22] P = .007). Multivariate analysis demonstrated that increasing age and clinical severity were associated with mortality. Transplant status itself was not associated with mortality., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2020
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