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COVID-19 Outcomes Among Solid Organ Transplant Recipients: A Case-Control Study
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1 01 2021
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Source: Transplantation. 105(1):128-137
[PDF-775.38 KB]
Details:
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Alternative Title:Transplantation
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Personal Author:
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Description:Background:
Solid organ transplant (SOT) recipients are considered to be “vulnerable” to COVID-19 infection due to immunosuppression. To date, there are no studies that compared the disease severity of COVID-19 in SOT recipients with nontransplant patients.
Methods:
In this case-control study, we compared the outcomes of COVID-19 between SOT recipients and their matched nontransplant controls. The cases were all adult SOT recipients (N=41) from our academic health center who were diagnosed with COVID-19 between 3/10/20 and 5/15/20 using positive reverse transcriptase polymerase chain reaction for SARS-CoV2. The controls(N=121) were matched on age(±5years), race, and admission status (hospital or outpatient). The primary outcome was death and secondary outcomes were severe disease, intubation and renal replacement therapy(RRT).
Results:
Median age of SOT recipients(9-heart, 3-lung, 16-kidney, 8-liver, 5-dual-organ) was 60 years, 80% were male and 67% were Black. Severe disease adjusted risk of death was similar in both the groups(HR=0.84[0.32–2.20]). Severity of COVID-19 and intubation were similar but the RRT use was higher in SOT (OR=5.32[1.26, 22.42]) compared to non-SOT COVID-19 patients. Among SOT recipients, COVID-19-related treatment with hydroxychloroquine (HCQ) was associated with ten-fold higher hazard of death compared to without HCQ (HR=10.62[1.24–91.09]).
Conclusions:
Although African-Americans constituted one-tenth of all SOT in our center, they represented two-thirds of COVID-19 cases. Despite high RRT use in SOT recipients, the severe disease and short-term death were similar in both groups. HCQ for the treatment of COVID-19 among SOT recipients was associated with high mortality and therefore, its role as a treatment modality requires further scrutiny.
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Source:
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Pubmed ID:32890139
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Pubmed Central ID:PMC7853506
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Funding:
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Volume:105
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Issue:1
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