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COVID‐19 in solid organ transplant recipients: A national cohort study from Sweden
Author(s) -
Søfteland John M.,
Friman Gustav,
ZurMühlen Bengt,
Ericzon BoGöran,
Wallquist Carin,
Karason Kristjan,
Friman Vanda,
Ekelund Jan,
Felldin Marie,
Magnusson Jesper,
Haugen Löfman Ida,
Schult Andreas,
Coursey Emily,
Leach Susannah,
Jacobsson Hanna,
Liljeqvist JanÅke,
Biglarnia Ali R.,
Lindnér Per,
Oltean Mihai
Publication year - 2021
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.16596
Subject(s) - medicine , asymptomatic , cohort , young adult , seroprevalence , antibody , immunology , serology
Solid organ transplant (SOT) recipients run a high risk for adverse outcomes from COVID‐19, with reported mortality around 19%. We retrospectively reviewed all known Swedish SOT recipients with RT‐PCR confirmed COVID‐19 between March 1 and November 20, 2020 and analyzed patient characteristics, management, and outcome. We identified 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%). Most patients were hospitalized (64%), but 36% remained outpatients. Age >50 and male sex were among predictors of transition from outpatient to inpatient status. National early warning Score 2 (NEWS2) at presentation was higher in non‐survivors. Thirty‐day all‐cause mortality was 9.6% (15.0% for inpatients), increased with age and BMI, and was higher in men. Renal function decreased during COVID‐19 but recovered in most patients. SARS‐CoV‐2 antibodies were identified in 78% of patients at 1–2 months post‐infection. Nucleocapsid‐specific antibodies decreased to 38% after 6–7 months, while spike‐specific antibody responses were more durable. Seroprevalence in 559 asymptomatic patients was 1.4%. Many patients can be managed on an outpatient basis aided by risk stratification with age, sex, and NEWS2 score. Factors associated with adverse outcomes include older age, male sex, greater BMI, and a higher NEWS2 score.