Longitudinal outcomes of COVID-19 in solid organ transplant recipients from 2020 to 2023
Details
Publication Year 2024-07,Volume 24,Issue #7,Page 1303-1316
Journal Title
American Journal of Transplantation
Publication Type
Research article
Abstract
Data regarding coronavirus disease 2019 (COVID-19) outcomes in solid organ transplant recipients (SOTr) across severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) waves, including the impact of different measures, are lacking. This cohort study, conducted from March 2020 to May 2023 in Toronto, Canada, aimed to analyze COVID-19 outcomes in 1975 SOTr across various SARS-CoV-2 waves and assess the impact of preventive and treatment measures. The primary outcome was severe COVID-19, defined as requiring supplemental oxygen, with secondary outcomes including hospitalization, length of stay, intensive care unit (ICU) admission, and 30-day and 1-year all-cause mortality. SARS-CoV-2 waves were categorized as Wildtype/Alpha/Delta (318 cases, 16.1%), Omicron BA.1 (268, 26.2%), Omicron BA.2 (268, 13.6%), Omicron BA.5 (561, 28.4%), Omicron BQ.1.1 (188, 9.5%), and Omicron XBB.1.5 (123, 6.2%). Severe COVID-19 rate was highest during the Wildtype/Alpha/Delta wave (44.6%), and lower in Omicron waves (5.7%-16.1%). Lung transplantation was associated with severe COVID-19 (OR: 4.62, 95% CI: 2.71-7.89), along with rituximab treatment (OR: 4.24, 95% CI: 1.04-17.3), long-term corticosteroid use (OR: 3.11, 95% CI: 1.46-6.62), older age (OR: 1.51, 95% CI: 1.30-1.76), chronic lung disease (OR: 2.11, 95% CI: 1.36-3.30), chronic kidney disease (OR: 2.18, 95% CI: 1.17-4.07), and diabetes (OR: 1.97, 95% CI: 1.37-2.83). Early treatment and ≥3 vaccine doses were associated with reduced severity (OR: 0.29, 95% CI: 0.19-0.46, and 0.35, 95% CI: 0.21-0.60, respectively). Tixagevimab/cilgavimab and bivalent boosters did not show a significant impact. The study concludes that COVID-19 severity decreased across different variants in SOTr. Lung transplantation was associated with worse outcomes and may benefit more from preventive and early therapeutic interventions.
Publisher
Elsevier
Keywords
Humans; *COVID-19/epidemiology; *Organ Transplantation/adverse effects; Male; Female; Middle Aged; *Transplant Recipients/statistics & numerical data; *SARS-CoV-2; Adult; Aged; Hospitalization/statistics & numerical data; Longitudinal Studies; Intensive Care Units; Canada/epidemiology; Covid-19; SARS-CoV-2; antivirals; bivalent booster vaccines; death; heart transplant; hospitalization; kidney transplant; liver transplant; lung transplant; mRNA; nirmatrelvir/ritonavir; outcomes; remdesivir; solid organ transplant; sotrovimab; tixagevimab/cilgavimab; vaccination; vaccines
Department(s)
Infectious Diseases
Open Access at Publisher's Site
https://doi.org/10.1016/j.ajt.2024.03.011
Terms of Use/Rights Notice
Refer to copyright notice on published article.


Creation Date: 2024-08-27 04:47:44
Last Modified: 2024-08-27 04:47:56

© 2024 The Walter and Eliza Hall Institute of Medical Research. Access to this website is subject to our Privacy Policy and Terms of Use

An error has occurred. This application may no longer respond until reloaded. Reload 🗙