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Outcomes of critically ill solid organ transplant patients with COVID‐19 in the United States

Authors :
Molnar, Miklos Z.
Bhalla, Anshul
Azhar, Ambreen
Tsujita, Makoto
Talwar, Manish
Balaraman, Vasanthi
Sodhi, Amik
Kadaria, Dipen
Eason, James D.
Hayek, Salim S.
Coca, Steven G.
Shaefi, Shahzad
Neyra, Javier A.
Gupta, Shruti
Leaf, David E.
Kovesdy, Csaba P.
Source :
American Journal of Transplantation; November 2020, Vol. 20 Issue: 11 p3061-3071, 11p
Publication Year :
2020

Abstract

National data on patient characteristics, treatment, and outcomes of critically ill coronavirus disease 2019 (COVID‐19) solid organ transplant (SOT) patients are limited. We analyzed data from a multicenter cohort study of adults with laboratory‐confirmed COVID‐19 admitted to intensive care units (ICUs) at 68 hospitals across the United States from March 4 to May 8, 2020. From 4153 patients, we created a propensity score matched cohort of 386 patients, including 98 SOT patients and 288 non‐SOT patients. We used a binomial generalized linear model (log‐binomial model) to examine the association of SOT status with death and other clinical outcomes. Among the 386 patients, the median age was 60 years, 72% were male, and 41% were black. Death within 28 days of ICU admission was similar in SOT and non‐SOT patients (40% and 43%, respectively; relative risk [RR] 0.92; 95% confidence interval [CI]: 0.70‐1.22). Other outcomes and requirement for organ support including receipt of mechanical ventilation, development of acute respiratory distress syndrome, and receipt of vasopressors were also similar between groups. There was a trend toward higher risk of acute kidney injury requiring renal replacement therapy in SOT vs. non‐SOT patients (37% vs. 27%; RR [95% CI]: 1.34 [0.97‐1.85]). Death and organ support requirement were similar between SOT and non‐SOT critically ill patients with COVID‐19. Solid organ transplant recipients with critical SARS‐CoV‐2 infection have a similar risk of death, acute respiratory distress syndrome, and requirement for organ support as nonsolid organ transplant patients.

Details

Language :
English
ISSN :
16006135 and 16006143
Volume :
20
Issue :
11
Database :
Supplemental Index
Journal :
American Journal of Transplantation
Publication Type :
Periodical
Accession number :
ejs54512386
Full Text :
https://doi.org/10.1111/ajt.16280