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Multicenter Study
. 2020 Nov;20(11):3061-3071.
doi: 10.1111/ajt.16280. Epub 2020 Sep 15.

Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Miklos Z Molnar  1   2   3 , Anshul Bhalla  1   2 , Ambreen Azhar  1   2 , Makoto Tsujita  1   2 , Manish Talwar  1   2 , Vasanthi Balaraman  1   2 , Amik Sodhi  4 , Dipen Kadaria  4 , James D Eason  1   2 , Salim S Hayek  5 , Steven G Coca  6 , Shahzad Shaefi  7 , Javier A Neyra  8 , Shruti Gupta  9 , David E Leaf  9 , Csaba P Kovesdy  3   10 ; STOP-COVID Investigators
Collaborators, Affiliations
Multicenter Study

Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Miklos Z Molnar et al. Am J Transplant. 2020 Nov.

Abstract

National data on patient characteristics, treatment, and outcomes of critically ill coronavirus disease 2019 (COVID-19) solid organ transplant (SOT) patients are limited. We analyzed data from a multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICUs) at 68 hospitals across the United States from March 4 to May 8, 2020. From 4153 patients, we created a propensity score matched cohort of 386 patients, including 98 SOT patients and 288 non-SOT patients. We used a binomial generalized linear model (log-binomial model) to examine the association of SOT status with death and other clinical outcomes. Among the 386 patients, the median age was 60 years, 72% were male, and 41% were black. Death within 28 days of ICU admission was similar in SOT and non-SOT patients (40% and 43%, respectively; relative risk [RR] 0.92; 95% confidence interval [CI]: 0.70-1.22). Other outcomes and requirement for organ support including receipt of mechanical ventilation, development of acute respiratory distress syndrome, and receipt of vasopressors were also similar between groups. There was a trend toward higher risk of acute kidney injury requiring renal replacement therapy in SOT vs. non-SOT patients (37% vs. 27%; RR [95% CI]: 1.34 [0.97-1.85]). Death and organ support requirement were similar between SOT and non-SOT critically ill patients with COVID-19.

Keywords: clinical research/practice; complication: infectious; infection and infectious agents - viral; infectious disease; kidney transplantation/nephrology; organ transplantation in general; patient survival.

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Figures

FIGURE 1
FIGURE 1
Flow chart of patient selection. COVID-19, coronavirus disease 2019; SOT, solid organ transplantation; ICU, intensive care unit; ESRD, end-stage renal disease
See this image and copyright information in PMC

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References

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