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American Journal of Transplantation ; 22(Supplement 3):639, 2022.
Article in English | EMBASE | ID: covidwho-2063507


Purpose: Despite the large numbers of reports on patient risk factors for poor clinical outcomes with COVID-19, little is known about how these risks may differ for solid organ transplant (SOT) recipients versus non-SOT (NSOT) patients. Method(s): We reviewed demographic and comorbid conditions in a cohort of SOT (n=129) and NSOT patients (n=708) admitted to our center for COVID-19 between December 2019 and February 2021. Patient characteristics were compared between groups using the t-test or chi-square test. Univariable and multivariable (stepwise reduced) logistic regression models were constructed for our outcomes of interest. Result(s): Patient age and sex were similar between SOT and NSOT cohorts. However, SOT patients were more likely to be of Hispanic ethnicity (64% v. 39%, p<0.001). Both SOT and NSOT had similar incidence of neurologic conditions (23% and 21%, p=0.476), but SOT patients were more likely to have comorbid conditions including diabetes mellitus, cardiovascular condition, or lung disease (all p<0.001). Several clinical factors were associated with ICU admission in NSOT patients, including patient age, diabetes, cardiac disease, neurologic disease, obesity, and hepatobiliary disease (all p < 0.05). In contrast, only cardiac disease was associated with ICU admission for SOT patients (p=0.010). Multivariable analysis of factors associated with increased mortality revealed that neurologic condition (OR 3.0, 95% CI 0.8-11.4) and lung disease (OR 3.5, 95% CI 0.7-18.2) were significant for SOT patients in a model including age, sex, and other comorbid conditions. In contrast, for NSOT patients, history of a neurologic condition (OR 2.3, 95% CI 1.3-4.0) and age >65 (OR 4.2, 95% CI 2.1-8.7) were significantly associated with death in a multivariate analysis. Conclusion(s): It has been previously unclear whether risk factors associated with poor outcomes in NSOT patients with COVID-19 will be similarly important in SOT recipients. Our analysis demonstrated different risk associations in contemporaneous patient cohorts at a single academic center. This observation suggests that SOT-specific approaches for risk stratification would be beneficial for patient evaluation and triage.

American Journal of Transplantation ; 21(SUPPL 4):622-623, 2021.
Article in English | EMBASE | ID: covidwho-1494559


Purpose: The COVID-19 pandemic has caused significant morbidity and mortality in patients around the world. A significant impact has been observed in immunocompromised patients such as solid organ transplant (SOT) recipients, with increased rates of intubation and mortality compared to non-transplant patients. Our aim was to analyze risk factors, clinical presentation, and outcomes at a single high volume transplant center. Methods: We reviewed the records of adult SOT recipients during the COVID-19 pandemic from March to October 2020 to identify 143 SOT recipients diagnosed with COVID-19 by SARS-CoV-2 PCR testing, the majority of whom required hospitalization. 12 cases were from pediatric patients and were excluded from further analysis, leaving 131 adult patients for analysis. Recipient demographics, clinical presentation, and outcomes were compared by transplant type. Results: Kidney transplant recipients comprised the majority of COVID-19 cases (n=87), followed by liver (n=18), lung (n=18), heart (n=7), and intestinal (n=1) transplants. Non-kidney transplant recipients were significantly older than kidney transplant recipients (n=0.005), while kidney transplant recipients were more likely to be overweight or obese (p=0.007) and have a diagnosis of hypertension (p<0.001) (Table). Time between transplant and positive COVID-19 PCR test, sex, ethnicity, incidence of diabetes, and coronary artery disease were similar across transplant types. Presenting symptoms were also comparable, with similar incidence of shortness of breath, cough, fever, nausea and vomiting, diarrhea, and loss of smell or taste. Mortality rates were not significantly different in the kidney compared with the non-kidney transplant recipients (p=0.478). Conclusions: Although presenting symptoms were similar, kidney transplant recipients with COVID-19 had significant differences in comorbidities compared with non-kidney transplant recipients. Future studies will compare mortality rate in transplant patients compared with non-transplant patients with COVID-19 at our center after adjusting for comorbidities, including diabetes, hypertension and obesity.

Dermatology Online Journal ; 27(2):15, 2021.
Article in English | MEDLINE | ID: covidwho-1168559