Longitudinal outcomes of COVID-19 in solid organ transplant recipients from 2020 to 2023
- Author(s)
- Solera, JT; Árbol, BG; Mittal, A; Hall, V; Marinelli, T; Bahinskaya, I; Selzner, N; McDonald, M; Schiff, J; Sidhu, A; Humar, A; Kumar, D;
- 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
- Publisher's Version
- https://doi.org/10.1016/j.ajt.2024.03.011
- 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