BACKGROUND: From population studies, solid organ transplant recipients are at increased risk of mortality from RT-PCR confirmed COVID-19 infection. The risk factors associated with infection acquisition and mortality in transplant recipients using serological data have not been reported. METHODS: From 1725 maintenance transplant recipients, 855 consecutive patients were screened for SARS-CoV-2 antibodies. Serological screening utilized assays to detect both the N protein and receptor binding domain antibodies. Thirty-three of 855 (3.9%) of the screened patients had prior infection confirmed with RT-PCR. Twenty-one additional patients from our 1725 maintenance cohort with RT-PCR confirmed infection were included in our analysis. RESULTS: Eighty-nine of 855 (10.4%) patients tested positive for SARS-CoV-2 antibodies. Fifty-nine of 89 (66.3%) cases were patients newly identified as exposed, while 30/89 (33.7%) seropositive patients had previous infection confirmed by RT-PCR. A diagnosis of SARS-CoV-2 (RT-PCR or Ab+) was associated with being from a noncaucasoid background, P = 0.015; having a diagnosis of diabetes, P = 0.028 and a history of allograft rejection, P < 0.01. Compared with the RT-PCR+ cohort, patients with serological-proven infection alone were more likely to be receiving tacrolimus monotherapy, P < 0.01, and less likely to have a diagnosis of diabetes, P = 0.012. Seventeen of 113 (15.0%) of all patients with infection (RT-PCR and Ab+) died. Risk factors associated with survival were older age, odds ratio (OR): 1.07 (1.00-1.13), P = 0.041; receiving prednisolone, OR: 5.98 (1.65-21.60), P < 0.01 and the absence of diabetes, OR: 0.27 (0.07-0.99), P = 0.047. CONCLUSIONS: This study identifies risk factors and outcome for COVID-19 infection incorporating data on serologically defined infection and highlights the important contribution of immunosuppression regimen on outcomes.
BACKGROUND: From population studies, solid organ transplant recipients are at increased risk of mortality from RT-PCR confirmed COVID-19infection. The risk factors associated with infection acquisition and mortality in transplant recipients using serological data have not been reported. METHODS: From 1725 maintenance transplant recipients, 855 consecutive patients were screened for SARS-CoV-2 antibodies. Serological screening utilized assays to detect both the N protein and receptor binding domain antibodies. Thirty-three of 855 (3.9%) of the screened patients had prior infection confirmed with RT-PCR. Twenty-one additional patients from our 1725 maintenance cohort with RT-PCR confirmed infection were included in our analysis. RESULTS: Eighty-nine of 855 (10.4%) patients tested positive for SARS-CoV-2 antibodies. Fifty-nine of 89 (66.3%) cases were patients newly identified as exposed, while 30/89 (33.7%) seropositive patients had previous infection confirmed by RT-PCR. A diagnosis of SARS-CoV-2 (RT-PCR or Ab+) was associated with being from a noncaucasoid background, P = 0.015; having a diagnosis of diabetes, P = 0.028 and a history of allograft rejection, P < 0.01. Compared with the RT-PCR+ cohort, patients with serological-proven infection alone were more likely to be receiving tacrolimus monotherapy, P < 0.01, and less likely to have a diagnosis of diabetes, P = 0.012. Seventeen of 113 (15.0%) of all patients with infection (RT-PCR and Ab+) died. Risk factors associated with survival were older age, odds ratio (OR): 1.07 (1.00-1.13), P = 0.041; receiving prednisolone, OR: 5.98 (1.65-21.60), P < 0.01 and the absence of diabetes, OR: 0.27 (0.07-0.99), P = 0.047. CONCLUSIONS: This study identifies risk factors and outcome for COVID-19infection incorporating data on serologically defined infection and highlights the important contribution of immunosuppression regimen on outcomes.
Authors: Luke Muir; Aneesa Jaffer; Chloe Rees-Spear; Vignesh Gopalan; Fernando Y Chang; Raymond Fernando; Gintare Vaitkute; Chloe Roustan; Annachiara Rosa; Christopher Earl; Gayathri K Rajakaruna; Peter Cherepanov; Alan Salama; Laura E McCoy; Reza Motallebzadeh Journal: Kidney Int Rep Date: 2021-04-28
Authors: Bastien Berger; Marc Hazzan; Nassim Kamar; Hélène Francois; Marie Matignon; Clarisse Greze; Philippe Gatault; Luc Frimat; Pierre F Westeel; Valentin Goutaudier; Renaud Snanoudj; Charlotte Colosio; Antoine Sicard; Dominique Bertrand; Christiane Mousson; Jamal Bamoulid; Antoine Thierry; Dany Anglicheau; Lionel Couzi; Jonathan M Chemouny; Agnes Duveau; Valerie Moal; Yannick Le Meur; Gilles Blancho; Jérôme Tourret; Paolo Malvezzi; Christophe Mariat; Jean-Philippe Rerolle; Nicolas Bouvier; Sophie Caillard; Olivier Thaunat Journal: Kidney Int Rep Date: 2022-09-21
Authors: Refik Gökmen; Antonia Cronin; Wendy Brown; Stephen Cass; Abbas Ghazanfar; Mohammad Ayaz Hossain; Jenny Johnson; Trish Longdon; Sue Lyon; Adam McLean; Reza Motallebzadeh; Joyce Popoola; Ayo Samuel; Raj Thuraisingham; Angela-Jane Wood; Frank J M F Dor Journal: Transpl Int Date: 2021-09-19 Impact factor: 3.842