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COVID-19 in solid organ transplant recipients : A national cohort study from Sweden

Søfteland, John M. ; Friman, Gustav ; von Zur-Mühlen, Bengt ; Ericzon, Bo Göran ; Wallquist, Carin LU ; Karason, Kristjan ; Friman, Vanda ; Ekelund, Jan ; Felldin, Marie and Magnusson, Jesper , et al. (2021) In American Journal of Transplantation 21(8). p.2762-2773
Abstract

Solid organ transplant (SOT) recipients run a high risk for adverse outcomes from COVID-19, with reported mortality around 19%. We retrospectively reviewed all known Swedish SOT recipients with RT-PCR confirmed COVID-19 between March 1 and November 20, 2020 and analyzed patient characteristics, management, and outcome. We identified 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%). Most patients were hospitalized (64%), but 36% remained outpatients. Age >50 and male sex were among predictors of transition from outpatient to inpatient status. National early warning Score 2 (NEWS2) at presentation was higher in non-survivors. Thirty-day all-cause mortality was 9.6% (15.0% for inpatients), increased... (More)

Solid organ transplant (SOT) recipients run a high risk for adverse outcomes from COVID-19, with reported mortality around 19%. We retrospectively reviewed all known Swedish SOT recipients with RT-PCR confirmed COVID-19 between March 1 and November 20, 2020 and analyzed patient characteristics, management, and outcome. We identified 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%). Most patients were hospitalized (64%), but 36% remained outpatients. Age >50 and male sex were among predictors of transition from outpatient to inpatient status. National early warning Score 2 (NEWS2) at presentation was higher in non-survivors. Thirty-day all-cause mortality was 9.6% (15.0% for inpatients), increased with age and BMI, and was higher in men. Renal function decreased during COVID-19 but recovered in most patients. SARS-CoV-2 antibodies were identified in 78% of patients at 1–2 months post-infection. Nucleocapsid-specific antibodies decreased to 38% after 6–7 months, while spike-specific antibody responses were more durable. Seroprevalence in 559 asymptomatic patients was 1.4%. Many patients can be managed on an outpatient basis aided by risk stratification with age, sex, and NEWS2 score. Factors associated with adverse outcomes include older age, male sex, greater BMI, and a higher NEWS2 score.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
clinical research / practice, health services and outcomes research, immunosuppressant, infection and infectious agents - viral, infectious disease, kidney (allograft) function / dysfunction, organ transplantation in general, patient characteristics, patient survival, COVID-19
in
American Journal of Transplantation
volume
21
issue
8
pages
2762 - 2773
publisher
Wiley-Blackwell
external identifiers
  • pmid:33811777
  • scopus:85104861983
ISSN
1600-6135
DOI
10.1111/ajt.16596
language
English
LU publication?
no
id
3495aca0-a924-4528-8f71-6e3662fa0155
date added to LUP
2021-05-10 12:10:55
date last changed
2024-09-07 19:01:03
@article{3495aca0-a924-4528-8f71-6e3662fa0155,
  abstract     = {{<p>Solid organ transplant (SOT) recipients run a high risk for adverse outcomes from COVID-19, with reported mortality around 19%. We retrospectively reviewed all known Swedish SOT recipients with RT-PCR confirmed COVID-19 between March 1 and November 20, 2020 and analyzed patient characteristics, management, and outcome. We identified 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%). Most patients were hospitalized (64%), but 36% remained outpatients. Age &gt;50 and male sex were among predictors of transition from outpatient to inpatient status. National early warning Score 2 (NEWS2) at presentation was higher in non-survivors. Thirty-day all-cause mortality was 9.6% (15.0% for inpatients), increased with age and BMI, and was higher in men. Renal function decreased during COVID-19 but recovered in most patients. SARS-CoV-2 antibodies were identified in 78% of patients at 1–2 months post-infection. Nucleocapsid-specific antibodies decreased to 38% after 6–7 months, while spike-specific antibody responses were more durable. Seroprevalence in 559 asymptomatic patients was 1.4%. Many patients can be managed on an outpatient basis aided by risk stratification with age, sex, and NEWS2 score. Factors associated with adverse outcomes include older age, male sex, greater BMI, and a higher NEWS2 score.</p>}},
  author       = {{Søfteland, John M. and Friman, Gustav and von Zur-Mühlen, Bengt and Ericzon, Bo Göran and Wallquist, Carin and Karason, Kristjan and Friman, Vanda and Ekelund, Jan and Felldin, Marie and Magnusson, Jesper and Haugen Löfman, Ida and Schult, Andreas and de Coursey, Emily and Leach, Susannah and Jacobsson, Hanna and Liljeqvist, Jan Åke and Biglarnia, Ali R. and Lindnér, Per and Oltean, Mihai}},
  issn         = {{1600-6135}},
  keywords     = {{clinical research / practice; health services and outcomes research; immunosuppressant; infection and infectious agents - viral; infectious disease; kidney (allograft) function / dysfunction; organ transplantation in general; patient characteristics; patient survival; COVID-19}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{2762--2773}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{American Journal of Transplantation}},
  title        = {{COVID-19 in solid organ transplant recipients : A national cohort study from Sweden}},
  url          = {{http://dx.doi.org/10.1111/ajt.16596}},
  doi          = {{10.1111/ajt.16596}},
  volume       = {{21}},
  year         = {{2021}},
}