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Clinical characteristics and outcomes of COVID‐19 in solid organ transplant recipients: A cohort study
Author(s) -
Chaudhry Zohra S.,
Williams Jonathan D.,
Vahia Amit,
Fadel Raef,
Parraga Acosta Tommy,
Prashar Rohini,
Shrivastava Pritika,
Khoury Nadeen,
Pinto Corrales Julio,
Williams Celeste,
Nagai Shunji,
Abouljoud Marwan,
SamaniegoPicota Milagros,
AbreuLanfranco Odaliz,
Busto Ramon,
Ramesh Mayur S.,
Patel Anita,
Alangaden George J.
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16188
Subject(s) - medicine , intensive care unit , confidence interval , immunosuppression , odds ratio , comorbidity , kidney disease , mechanical ventilation , cohort study , cohort , diabetes mellitus , surgery , endocrinology
Solid organ transplant recipients (SOTr) with coronavirus disease 2019 (COVID‐19) are expected to have poorer outcomes compared to nontransplant patients because of immunosuppression and comorbidities. The clinical characteristics of 47 SOTr (38 kidneys and 9 nonkidney organs) were compared to 100 consecutive hospitalized nontransplant controls. Twelve of 47 SOTr managed as outpatients were subsequently excluded from the outcome analyses to avoid potential selection bias. Chronic kidney disease (89% vs 57% P = .0007), diabetes (66% vs 33% P = .0007), and hypertension (94% vs 72% P = .006) were more common in the 35 hospitalized SOTr compared to controls. Diarrhea (54% vs 17%, P < .0001) was more frequent in SOTr. Primary composite outcome (escalation to intensive care unit, mechanical ventilation, or in‐hospital all‐cause mortality) was comparable between SOTr and controls (40% vs 48%, odds ratio [OR] 0.72 confidence interval [CI] [0.33‐1.58] P = .42), despite more comorbidities in SOTr. Acute kidney injury requiring renal replacement therapy occurred in 20% of SOTr compared to 4% of controls (OR 6 CI [1.64‐22] P = .007). Multivariate analysis demonstrated that increasing age and clinical severity were associated with mortality. Transplant status itself was not associated with mortality.