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Impact of solid organ transplant status on outcomes of hospitalized patients with COVID-19 infection.
Schaenman, Joanna; Byford, Hannah; Grogan, Tristan; Motwani, Yash; Beaird, Omer E; Kamath, Megan; Lum, Erik; Meneses, Katherine; Sayah, David; Vucicevic, Darko; Saab, Sammy.
  • Schaenman J; Division of Infectious Diseases, University of California at Los Angeles, Los Angeles, California, USA.
  • Byford H; Transplant Nephrology, University of California at Los Angeles, Los Angeles, California, USA.
  • Grogan T; Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, Los Angeles, California, USA.
  • Motwani Y; Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, Los Angeles, California, USA.
  • Beaird OE; Division of Infectious Diseases, University of California at Los Angeles, Los Angeles, California, USA.
  • Kamath M; Division of Cardiology, University of California at Los Angeles, Los Angeles, California, USA.
  • Lum E; Transplant Nephrology, University of California at Los Angeles, Los Angeles, California, USA.
  • Meneses K; Transplant Hepatology, University of California at Los Angeles, Los Angeles, California, USA.
  • Sayah D; Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
  • Vucicevic D; Division of Cardiology, University of California at Los Angeles, Los Angeles, California, USA.
  • Saab S; Transplant Hepatology, University of California at Los Angeles, Los Angeles, California, USA.
Transpl Infect Dis ; 24(4): e13853, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1846302
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has caused significant morbidity and mortality in solid organ transplant (SOT) recipients. However, it remains unclear whether the risk factor for SOT patients is the immunosuppression inherent to transplantation versus patient comorbidities.

METHODS:

We reviewed outcomes in a cohort of SOT (n = 129) and non-SOT (NSOT) patients (n = 708) admitted to the University of California, Los Angeles for COVID-19 infection. Data analyses utilized multivariate logistic regression to evaluate the impact of patient demographics, comorbidities, and transplant status on outcomes. SOT patients were analyzed by kidney SOT (KSOT) versus nonkidney SOT (NKSOT) groups.

RESULTS:

SOT and NSOT patients with COVID-19 infection differed in terms of patient age, ethnicity, and comorbidities. NKSOT patients were the most likely to experience death, with a mortality rate of 16.2% compared with 1.8% for KSOT and 8.3% for NSOT patients (p = .013). Multivariable analysis of hospitalized patients revealed that patient age (odds ratio [OR] 2.79, p = .001) and neurologic condition (OR 2.66, p < .001) were significantly associated with mortality. Analysis of ICU patients revealed a 2.98-fold increased odds of death in NKSOT compared with NSOT patients (p = .013).

CONCLUSIONS:

This study demonstrates the importance of transplant status in predicting adverse clinical outcomes in patients hospitalized or admitted to the ICU with COVID-19, especially for NKSOT patients. Transplant status and comorbidities, including age, could be used to risk stratify patients with COVID-19. This data suggests that immunosuppression contributes to COVID-19 disease severity and mortality and may have implications for managing immunosuppression, especially for critically ill patients admitted to the ICU.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Transpl Infect Dis Journal subject: Transplantation Year: 2022 Document Type: Article Affiliation country: Tid.13853

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Organ Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Transpl Infect Dis Journal subject: Transplantation Year: 2022 Document Type: Article Affiliation country: Tid.13853