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Comparative Study
. 2024 Oct;26(5):e14333.
doi: 10.1111/tid.14333. Epub 2024 Jul 9.

Risk factors for severe outcomes of coronavirus disease 2019 through the waves of the pandemic: Comparing patients with and without solid organ transplantation

Stephen B Lee  1 , Ran Dai  2 , Evan French  3 , Jerrod A Anzalone  2 , Amy L Olex  3 , Jin Ge  4 , Makayla Schissel  2 , Gaurav Agarwal  5 , Amanda Vinson  6 , Vithal Madhira  7 , Roslyn B Mannon  8 ; N3C Consortium
Affiliations
Comparative Study

Risk factors for severe outcomes of coronavirus disease 2019 through the waves of the pandemic: Comparing patients with and without solid organ transplantation

Stephen B Lee et al. Transpl Infect Dis. 2024 Oct.

Abstract

Background: While coronavirus disease 2019 (COVID-19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic.

Methods: Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID-19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID-19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT.

Results: A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID-19-associated outcomes over time. In both non-SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID-19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group.

Conclusions: Our study provides a longitudinal view of the risks associated with adverse COVID-related outcomes amongst SOT and non-SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high-risk patients.

Keywords: COVID; COVID‐19; N3C; SARS‐CoV‐2; solid organ transplantation; transplantation.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Dr. Jin Ge receives research support from Merck and Co.; and consults for Astellas Pharmaceuticals/Iota Biosciences. Dr. Roslyn Mannon receives grant funding from VericiDx and is a consultant for Sanofi, Hibio, CSL Behring, Natera, and Chinook. Dr. Amanda Vinson is a consultant for Paladin Labs Inc. and Taketa Pharmaceuticals.

Figures

FIGURE 1
FIGURE 1
Change in Outcomes over Time (major adverse renal and cardiac events [MARCE]: Pre-vaccine 57.7% (4179), Delta 48.1% (3216), Omicron 43.1% (4612), p < 0.001; Hospitalization: Pre-vaccine 53% (3846), Delta 42.4% (2835), Omicron 38.4% (4,109), p < 0.001; Death: Pre-vaccine 9.7% (704), Delta 10.1% (678), Omicron 5.7% (610), p < 0.001).
FIGURE 1
FIGURE 1
Change in Outcomes over Time (major adverse renal and cardiac events [MARCE]: Pre-vaccine 57.7% (4179), Delta 48.1% (3216), Omicron 43.1% (4612), p < 0.001; Hospitalization: Pre-vaccine 53% (3846), Delta 42.4% (2835), Omicron 38.4% (4,109), p < 0.001; Death: Pre-vaccine 9.7% (704), Delta 10.1% (678), Omicron 5.7% (610), p < 0.001).
FIGURE 2
FIGURE 2
(A) Risk factors for major adverse renal and cardiac events (MARCE) in solid organ transplant and non-solid organ transplant populations. (B) Risk factors for hospitalization in solid organ transplant and non-solid organ transplant populations. (C) Risk factors for death in solid organ transplant and non-solid organ transplant populations.
See this image and copyright information in PMC

References

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