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COVID-19 Outcomes Among Solid Organ Transplant Recipients: A Case-control Study.
Sharma, Pratima; Chen, Vincent; Fung, Christopher M; Troost, Jonathan P; Patel, Vaiibhav N; Combs, Michael; Norman, Silas; Garg, Puneet; Colvin, Monica; Aaronson, Keith; Sonnenday, Christopher J; Golob, Jonathan L; Somers, Emily C; Doshi, Mona M.
  • Sharma P; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Chen V; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Fung CM; Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Troost JP; Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI.
  • Patel VN; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Combs M; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Norman S; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Garg P; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Colvin M; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Aaronson K; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Sonnenday CJ; Department of Surgery, School of Public Health, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Golob JL; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Somers EC; Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI.
  • Doshi MM; Environmental Health Sciences, School of Public Health, Michigan Medicine, University of Michigan, Ann Arbor, MI.
Transplantation ; 105(1): 128-137, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1050222
ABSTRACT

BACKGROUND:

Solid organ transplant (SOT) recipients are considered to be "vulnerable" to COVID-19 infection due to immunosuppression. To date, there are no studies that compared the disease severity of COVID-19 in SOT recipients with nontransplant patients.

METHODS:

In this case-control study, we compared the outcomes of COVID-19 between SOT recipients and their matched nontransplant controls. The cases were all adult SOT recipients (N = 41) from our academic health center who were diagnosed with COVID-19 between March 10, 2020 and May 15, 2020 using positive reverse transcriptase polymerase chain reaction for SARS-CoV2. The controls (N = 121) were matched on age (±5 y), race, and admission status (hospital or outpatient). The primary outcome was death and secondary outcomes were severe disease, intubation and renal replacement therapy (RRT).

RESULTS:

Median age of SOT recipients (9 heart, 3 lung, 16 kidney, 8 liver, and 5 dual organ) was 60 y, 80% were male and 67% were Black. Severe disease adjusted risk of death was similar in both the groups (hazard ratio = 0.84 [0.32-2.20]). Severity of COVID-19 and intubation were similar, but the RRT use was higher in SOT (odds ratio = 5.32 [1.26, 22.42]) compared to non-SOT COVID-19 patients. Among SOT recipients, COVID-19-related treatment with hydroxychloroquine (HCQ) was associated with 10-fold higher hazard of death compared to without HCQ (hazard ratio = 10.62 [1.24-91.09]).

CONCLUSIONS:

Although African Americans constituted one-tenth of all SOT in our center, they represented two-thirds of COVID-19 cases. Despite high RRT use in SOT recipients, the severe disease and short-term death were similar in both groups. HCQ for the treatment of COVID-19 among SOT recipients was associated with high mortality and therefore, its role as a treatment modality requires further scrutiny.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Transplantation Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Transplantation Year: 2021 Document Type: Article