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. 2021 Oct 6;7(11):e775.
doi: 10.1097/TXD.0000000000001234. eCollection 2021 Nov.

COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Amanda J Vinson  1 , Gaurav Agarwal  2 , Ran Dai  3 , Alfred J Anzalone  3 , Stephen B Lee  4 , Evan French  5 , Amy Olex  5 , Vithal Madhira  6 , Roslyn B Mannon  7
Affiliations

COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Amanda J Vinson et al. Transplant Direct. .

Abstract

Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States.

Methods: In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored.

Results: Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss.

Conclusions: In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.

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Conflict of interest statement

A.J.V. has done consultancy work and received funding for a fellowship project grant through Paladin Labs Inc. G.A. has received educational funds from Mallinckrodt Pharmaceuticals and has served as principal investigator for studies by Mallinckrodt Pharmaceuticals and CSL Behring. R.B.M. reports grants from Mallinckrodt, Care Dx, CSL Behring, Transplant Genomics, Astellas, and Quark Pharmaceuticals; personal fees from Vitaerris as member of the IMAGINE Trial Steering committee; personal fees from Novartis, Sanofi, and Hansa; and personal fees from American Journal of Transplantation as Deputy Editor of the journal, outside the submitted work. The other authors declare no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Outcomes after coronavirus disease 2019 (COVID-19) diagnosis in solid organ transplant recipients. AKI, acute kidney injury; COVID−, negative result from COVID-19 testing; COVID+, positive result from COVID-19 testing; Covid-severity >moderate, need for hospitalization, ventilation, ECMO, or death from COVID-19; MACE, major adverse cardiac event; MARCE, major adverse renal or cardiac event.
See this image and copyright information in PMC

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