Solid organ transplant recipients and healthcare burden in covid19 era

ABSTRACT

Purpose: Pneumonia(PNA)-Acute inflammation of the lung parenchyma from an infection, is a frequent cause for hospitalization among Solid Organ Transplant Recipients (SOTRs), adversely effecting patient survival and healthcare costs. We assessed the healthcare impact associated with intensive care unit (ICU) hospitalization amongst SOTRs with COVID19 PNA or other serious PNAs. Methods: We performed a single center retrospective analysis of SOTRs admitted to the ICU with any PNA during March 2019-October 2019 or with COVID19 PNA during March 2020-October 2020. Using t-tests and Chi Square tests we compared SOTRs with severe COVID19 PNA to those with other severe PNAs. Results: 53 SOTRs with severe PNAs were included 26 with COVID19 PNA and 27 with other PNAs (Bacterial 56%, Fungal 30%, Viral 14%). Both the groups were similar in demographics, time since transplant, length of stay and acute dialysis needs (Table 1). Mortality was higher in SOTRs with COVID19 PNA compared to other PNAs (46% Vs 22%;p 0.07). Hospitalization costs was greater in those with other PNAs compared to COVID19 PNAs ($553,000 VS $196,000;p 0.006) with fungal PNAs being associated with greatest costs (Figure1). Conclusions: Critically ill SOTRs have substantially burdened the healthcare system with COVID19 associated mortality and healthcare expenses with other infections of equal severity. Every effort must be made to ensure timely assessment and diagnosis to minimize healthcare strains during this pandemic.