Article ; Online: COVID-19 in Solid Organ Transplantation: Disease Severity and Clinical Update.
2021 Volume 53, Issue 4, Page(s) 1227–1236
Abstract: ... patients had severe COVID-19 (34.5%) and 38 had nonsevere disease (65.5%). Severe disease was more common ... immunosuppression, and diagnosis month did not differ among those with severe and nonsevere COVID-19. Seventy ... percent of SOT recipients were hospitalized vs 27.2% of general patients with COVID-19 and inpatient SOT ...
| Abstract | Background: Solid organ transplant (SOT) recipients are a complex, immunocompromised population in whom greater coronavirus disease 2019 (COVID-19) mortality has been reported compared with the general population. Methods: We examined a retrospective cohort of 58 SOT recipients with first-wave COVID-19, comparing patients with severe and nonsevere illness. Additionally, SOT recipients are compared with general patients with first-wave COVID-19. Results: Organs transplanted included 38 kidneys, 8 livers, 5 hearts, and 3 pancreases. Average SOT recipient age was 57.4 years; 62% were male; 46.6% were African American 36.2% were white. Comorbidities included hypertension (86%), chronic kidney disease (86%), diabetes mellitus (50%), coronary artery disease (26%), and chronic obstructive pulmonary disease (14%). Twenty patients had severe COVID-19 (34.5%) and 38 had nonsevere disease (65.5%). Severe disease was more common in older SOT recipients with comorbidities and was associated with cough, dyspnea, pneumonia, C-reactive protein >10 mg/L, and platelet count <150/μL. Sex, race, body mass index, time from transplant, baseline immunosuppression, and diagnosis month did not differ among those with severe and nonsevere COVID-19. Seventy percent of SOT recipients were hospitalized vs 27.2% of general patients with COVID-19 and inpatient SOT recipients had a higher mechanical ventilation rate. Though a trend toward longer length of stay, higher intensive care unit admission, and greater inpatient mortality was observed (19.5% vs 14.8%), these differences were not significant. Conclusions: The severe acute respiratory syndrome coronavirus 2 has greatly impacted SOT recipients. One-third of our SOT recipients seen during the first wave had severe illness with associated standard risk factors for poor outcome. Compared with general first-wave patients, more SOT recipients were hospitalized, although inpatient COVID-19 mortality did not significantly differ. |
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| MeSH term(s) | Adult ; Aged ; C-Reactive Protein/analysis ; COVID-19/pathology ; COVID-19/virology ; Comorbidity ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Organ Transplantation ; Platelet Count ; Respiration, Artificial ; Retrospective Studies ; Severity of Illness Index |
| Chemical Substances | C-Reactive Protein (9007-41-4) |
| Language | English |
| Publishing date | 2021-02-25 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 82046-5 |
| ISSN | 1873-2623 ; 0041-1345 |
| ISSN (online) | 1873-2623 |
| ISSN | 0041-1345 |
| DOI | 10.1016/j.transproceed.2021.02.014 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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