Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug;24(4):e13853.
doi: 10.1111/tid.13853. Epub 2022 Jun 13.

Impact of solid organ transplant status on outcomes of hospitalized patients with COVID-19 infection

Joanna Schaenman  1 , Hannah Byford  2 , Tristan Grogan  3 , Yash Motwani  3 , Omer E Beaird  1 , Megan Kamath  4 , Erik Lum  2 , Katherine Meneses  5 , David Sayah  6 , Darko Vucicevic  4 , Sammy Saab  5
Affiliations
Review

Impact of solid organ transplant status on outcomes of hospitalized patients with COVID-19 infection

Joanna Schaenman et al. Transpl Infect Dis. 2022 Aug.

Abstract

Background: The COVID-19 pandemic has caused significant morbidity and mortality in solid organ transplant (SOT) recipients. However, it remains unclear whether the risk factor for SOT patients is the immunosuppression inherent to transplantation versus patient comorbidities.

Methods: We reviewed outcomes in a cohort of SOT (n = 129) and non-SOT (NSOT) patients (n = 708) admitted to the University of California, Los Angeles for COVID-19 infection. Data analyses utilized multivariate logistic regression to evaluate the impact of patient demographics, comorbidities, and transplant status on outcomes. SOT patients were analyzed by kidney SOT (KSOT) versus nonkidney SOT (NKSOT) groups.

Results: SOT and NSOT patients with COVID-19 infection differed in terms of patient age, ethnicity, and comorbidities. NKSOT patients were the most likely to experience death, with a mortality rate of 16.2% compared with 1.8% for KSOT and 8.3% for NSOT patients (p = .013). Multivariable analysis of hospitalized patients revealed that patient age (odds ratio [OR] 2.79, p = .001) and neurologic condition (OR 2.66, p < .001) were significantly associated with mortality. Analysis of ICU patients revealed a 2.98-fold increased odds of death in NKSOT compared with NSOT patients (p = .013).

Conclusions: This study demonstrates the importance of transplant status in predicting adverse clinical outcomes in patients hospitalized or admitted to the ICU with COVID-19, especially for NKSOT patients. Transplant status and comorbidities, including age, could be used to risk stratify patients with COVID-19. This data suggests that immunosuppression contributes to COVID-19 disease severity and mortality and may have implications for managing immunosuppression, especially for critically ill patients admitted to the ICU.

Keywords: COVID-19; comorbidities; solid organ transplant.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Consort diagram demonstrating identification of patient cohort for analysis. Abbreviations: ECMO, extracorporeal membrane oxygenation; NSOT, nonsolid organ transplant; RRMC, Ronald Reagan UCLA Medical Center; SOT, solid organ transplant; UCLA, University of California, Los Angeles
See this image and copyright information in PMC

Comment in

References

    1. Organization WH . WHO coronavirus (COVID‐19) dashboard. 2022. Accessed on May 8, 2022. https://covid19.who.int
    1. Bonifacius A, Tischer‐Zimmermann S, Dragon AC, et al. COVID‐19 immune signatures reveal stable antiviral T cell function despite declining humoral responses. Immunity. 2021;54(2):340‐354.e346. - PMC - PubMed
    1. Ni L, Cheng ML, Feng Y, et al. Impaired cellular immunity to SARS‐CoV‐2 in severe COVID‐19 patients. Front Immunol. 2021;12:603563. - PMC - PubMed
    1. Kumar D, Michaels MG, Morris MI, et al. Outcomes from pandemic influenza A H1N1 infection in recipients of solid‐organ transplants: a multicentre cohort study. Lancet Infect Dis. 2010;10(8):521‐526. - PMC - PubMed
    1. Koutsakos M, Rowntree LC, Hensen L, et al. Integrated immune dynamics define correlates of COVID‐19 severity and antibody responses. Cell Rep Med. 2021;2(3):100208. - PMC - PubMed