Outcomes of COVID-19 in Solid Organ Transplant Recipients in Canada 2020-2021: A Prospective, Multicenter Cohort Study
American Journal of Transplantation
; 22(Supplement 3):646-647, 2022.
Article
in English
| EMBASE | ID: covidwho-2063459
ABSTRACT
Purpose:
To understand the outcomes and changes in disease severity of COVID-19 in Solid Organ Transplant (SOT) recipients over time in the context of therapeutic advances. Method(s) We performed a multicenter, prospective cohort study of all SOT recipients diagnosed with COVID-19, across 9 transplant programs in Canada, from March 2020-November 2021. Baseline characteristics, demographics, treatment and disease severity outcomes were collected. The primary outcome was need for supplemental oxygen. Factors associated with the primary outcome and changes in outcomes over time were analyzed. Pandemic time periods were divided into four time frames coinciding with 4 waves in North America. Result(s) We enrolled 509 SOT recipients with confirmed COVID-19 during the study period. The risk factors associated with oxygen requirement are outlined in Table 1. Severe disease and mortality were greatest in lung transplant recipients compared to other organ types (15/48 (31.3%) lung deaths vs 63/461(13.7%) nonlung organs, (p=0.001). There was no influence of 2-dose vaccination and 3 patients were infected after 3-dose vaccine. Disease with alpha or delta variant was not associated with increased oxygen requirement. In a subgroup analysis of participants requiring oxygen (n=190), remdesivir was associated with less death (p=0.035). Over the pandemic period (Figure 1), there were no significant changes in the proportion of patients requiring oxygen, ICU admission, ventilatory support or death. (Table Presented) Conclusion(s) COVID-19 is especially severe in lung transplant recipients and immunosuppression plays a significant role. The outcomes associated with COVID-19 in SOT have not appreciably changed over time despite the emergence of novel variants and changes in therapeutic regimens.
adult; assisted ventilation; Canada; cohort analysis; conference abstract; coronavirus disease 2019; demographics; drug therapy; female; graft recipient; human; immunosuppressive treatment; lung; major clinical study; male; mortality; multicenter study; nonhuman; North America; outcome assessment; pandemic; prospective study; risk factor; SARS-CoV-2 Delta; surgery; vaccination; oxygen; remdesivir; vaccine
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal:
American Journal of Transplantation
Year:
2022
Document Type:
Article
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