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. 2021 Jul;21(7):2509-2521.
doi: 10.1111/ajt.16428. Epub 2021 Jan 20.

Incidence and outcome of SARS-CoV-2 infection on solid organ transplantation recipients: A nationwide population-based study

Silvia Trapani  1 , Lucia Masiero  1 , Francesca Puoti  1 , Maria C Rota  2 , Martina Del Manso  2 , Letizia Lombardini  1 , Flavia Riccardo  2 , Antonio Amoroso  3 , Patrizio Pezzotti  2 , Paolo A Grossi  4 , Silvio Brusaferro  5 , Massimo Cardillo  1 ; Italian Network of Regional Transplant Coordinating Centers Collaborating group; Italian Surveillance System of Covid-19, Italian Society for Organ Transplantation (SITO), The Italian Board of Experts in Liver Transplantation (I-BELT) Study Group, Italian Association for the Study of the Liver (AISF), Italian Society of Nephrology (SIN), SIN-SITO Study Group
Collaborators, Affiliations

Incidence and outcome of SARS-CoV-2 infection on solid organ transplantation recipients: A nationwide population-based study

Silvia Trapani et al. Am J Transplant. 2021 Jul.

Abstract

Since February 21 2020, when the Italian National Institute of Health (Istituto Superiore di Sanità-ISS) reported the first autochthonous case of infection, a dedicated surveillance system for SARS-CoV-2-positive (COVID+) cases has been created in Italy. These data were cross-referenced with those inside the Information Transplant System in order to assess the cumulative incidence (CI) and the outcome of SARS-COV-2 infection in solid organ transplant recipients (SOTRs) who are assumed to be most at risk. We compared our results with those of COVID+ nontransplanted patients (Non-SOTRs) with follow-up through September 30, 2020. The CI of SARS-CoV-2 infection in SOTRs was 1.02%, higher than in COVID+ Non-SOTRs (0.4%, p < .05) with a greater risk in the Lombardy region (2.89%). The CI by type of organ transplant was higher for heart (CI 1.57%, incidence rate ratio [IRR] 1.36) and lower for liver (CI 0.63%, IRR 0.54). The 60-day CI of mortality was 30.6%, twice as much that of COVID+ Non-SOTRs (15.4%) with a 60-day gender and age adjusted odds ratio (adjusted-OR) of 3.83 for COVID+ SOTRs (95% confidence interval [3.03-4.85]). The lowest 60-day adjusted-OR was observed in liver SOTRs (OR 0.46, 95% confidence interval [0.25-0.86]). More detailed studies on disease management and evolution will be necessary in these patients at greater risk of COVID-19.

Keywords: clinical research/practice; epidemiology; health services and outcomes research; infection and infectious agents; infectious disease; organ transplantation in general; patient survival.

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Figures

FIGURE 1
FIGURE 1
Data flow chart: (1) Data linkage - personal data of all patients entered in the COVID-19 surveillance system from February 21 to June 22, 2020 were cross-referenced with all SOTRs recorded in the SIT from January 1, 2002 to June 22, 2020; (2) NGF exclusion – all SOTRs, both SARS-CoV-2-positive and-negative, who had a graft failure were excluded from the study [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Kaplan-Meier cumulative incidence curves for mortality. (A) Time to death in COVID+ patients: SOTRS and Non-SOTRs. (B) Time to death in COVID+ SOTRs: kidney, liver, heart, lung, and pancreas recipients
See this image and copyright information in PMC

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