BACKGROUND: Solid organ transplant (SOT) recipients are considered to be "vulnerable" to COVID-19 infection due to immunosuppression. To date, there are no studies that compared the disease severity of COVID-19 in SOT recipients with nontransplant patients. METHODS: In this case-control study, we compared the outcomes of COVID-19 between SOT recipients and their matched nontransplant controls. The cases were all adult SOT recipients (N = 41) from our academic health center who were diagnosed with COVID-19 between March 10, 2020 and May 15, 2020 using positive reverse transcriptase polymerase chain reaction for SARS-CoV2. The controls (N = 121) were matched on age (±5 y), race, and admission status (hospital or outpatient). The primary outcome was death and secondary outcomes were severe disease, intubation and renal replacement therapy (RRT). RESULTS: Median age of SOT recipients (9 heart, 3 lung, 16 kidney, 8 liver, and 5 dual organ) was 60 y, 80% were male and 67% were Black. Severe disease adjusted risk of death was similar in both the groups (hazard ratio = 0.84 [0.32-2.20]). Severity of COVID-19 and intubation were similar, but the RRT use was higher in SOT (odds ratio = 5.32 [1.26, 22.42]) compared to non-SOT COVID-19 patients. Among SOT recipients, COVID-19-related treatment with hydroxychloroquine (HCQ) was associated with 10-fold higher hazard of death compared to without HCQ (hazard ratio = 10.62 [1.24-91.09]). CONCLUSIONS: Although African Americans constituted one-tenth of all SOT in our center, they represented two-thirds of COVID-19 cases. Despite high RRT use in SOT recipients, the severe disease and short-term death were similar in both groups. HCQ for the treatment of COVID-19 among SOT recipients was associated with high mortality and therefore, its role as a treatment modality requires further scrutiny.
BACKGROUND: Solid organ transplant (SOT) recipients are considered to be "vulnerable" to COVID-19 infection due to immunosuppression. To date, there are no studies that compared the disease severity of COVID-19 in SOT recipients with nontransplant patients. METHODS: In this case-control study, we compared the outcomes of COVID-19 between SOT recipients and their matched nontransplant controls. The cases were all adult SOT recipients (N = 41) from our academic health center who were diagnosed with COVID-19 between March 10, 2020 and May 15, 2020 using positive reverse transcriptase polymerase chain reaction for SARS-CoV2. The controls (N = 121) were matched on age (±5 y), race, and admission status (hospital or outpatient). The primary outcome was death and secondary outcomes were severe disease, intubation and renal replacement therapy (RRT). RESULTS: Median age of SOT recipients (9 heart, 3 lung, 16 kidney, 8 liver, and 5 dual organ) was 60 y, 80% were male and 67% were Black. Severe disease adjusted risk of death was similar in both the groups (hazard ratio = 0.84 [0.32-2.20]). Severity of COVID-19 and intubation were similar, but the RRT use was higher in SOT (odds ratio = 5.32 [1.26, 22.42]) compared to non-SOT COVID-19 patients. Among SOT recipients, COVID-19-related treatment with hydroxychloroquine (HCQ) was associated with 10-fold higher hazard of death compared to without HCQ (hazard ratio = 10.62 [1.24-91.09]). CONCLUSIONS: Although African Americans constituted one-tenth of all SOT in our center, they represented two-thirds of COVID-19 cases. Despite high RRT use in SOT recipients, the severe disease and short-term death were similar in both groups. HCQ for the treatment of COVID-19 among SOT recipients was associated with high mortality and therefore, its role as a treatment modality requires further scrutiny.
Authors: Chiara Cantarelli; Andrea Angeletti; Laura Perin; Luis Sanchez Russo; Gianmarco Sabiu; Manuel Alfredo Podestà; Paolo Cravedi Journal: Clin Kidney J Date: 2022-07-27
Authors: Christopher N Kanaan; Jean-Pierre Iskandar; Mohamed M Gad; Nicholas P Kondoleon; Saeid Mirzai; Eileen M Hsich; Jerry D Estep; Maan A Fares Journal: Transplant Proc Date: 2022-06-16 Impact factor: 1.014
Authors: Riad El Fakih; Alfadil Haroon; Feras Alfraih; Murtadha K Al-Khabori; Mohsen Alzahrani; Ahmad Alhuraiji; Abdulaziz Hamadah; Naif I AlJohani; Bader Alahmari; Mohammed F Essa; Ibraheem H Motabi; Imran K Tailor; Reem S Almaghrabi; Khalil Al-Farsi; Ibraheem Abosoudah; Mouhab Ayas; Tusneem A Elhassan; Ashraf M Suhebeh; Syed Osman Ahmed; Saud Alhayli; Panayotis Kaloyannidis; Ahmad Alsaeed; Khalid Al Anezi; Sameer Alamoudi; Moussab Damlaj; Hani Al Hashmi; Mahmoud Aljurf Journal: Bone Marrow Transplant Date: 2021-04-27 Impact factor: 5.483
Authors: Marcus R Pereira; Selim Arcasoy; Maryjane A Farr; Sumit Mohan; Jean C Emond; Demetra S Tsapepas; Qiuhu Shi; Lawrence Purpura; Anne-Catrin Uhlemann; Jason Zucker; Elizabeth C Verna Journal: Transpl Infect Dis Date: 2021-05-31
Authors: Deborah A Theodore; William G Greendyke; Benjamin Miko; Susan Whittier; Daniel A Green; Sherif Shoucri; Elizabeth C Verna; Jason Zucker; Magdalena E Sobieszczyk; Justin G Aaron; Brian E Scully; Lisa Saiman; Marcus Pereira; E Yoko Furuya Journal: Transplantation Date: 2021-07-01 Impact factor: 5.385
Authors: Tanner Corse; Linda Dayan; Sydney Kersten; Fortunato Battaglia; Stanley R Terlecky; Zhiyong Han Journal: Int J Med Sci Date: 2020-10-18 Impact factor: 3.738