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    COVID-19 in solid organ transplant: A multi-center cohort study

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    Sehgal-PrePrint-2020.pdf
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    Genre
    Pre-print
    Date
    2020-08-07
    Author
    Kates, Olivia S.
    Haydel, Brandy M.
    Florman, Sander S.
    Rana, Meenakshi M.
    Chaudhry, Zohra S.
    Ramesh, Mayur S.
    Safa, Kassem
    Kotton, Camille Nelson
    Blumberg, Emily A.
    Besharatian, Behdad D.
    Tanna, Sajal D.
    Ison, Michael G.
    Malinis, Maricar
    Azar, Marwan M.
    Rakita, Robert M.
    Morilla, Jose A.
    Majeed, Aneela
    Sait, Afrah S.
    Spaggiari, Mario
    Hemmige, Vagish
    Mehta, Sapna A.
    Neumann, Henry
    Badami, Abbasali
    Goldman, Jason D.
    Lala, Anuradha
    Hemmersbach-Miller, Marion
    McCort, Margaret E.
    Bajrovic, Valida
    Ortiz-Bautista, Carlos
    Friedman-Moraco, Rachel
    Sehgal, Sameep
    Lease, Erika D.
    Fisher, Cynthia E.
    Limaye, Ajit P.
    Show allShow less
    Department
    Thoracic Medicine And Surgery
    Subject
    COVID-19
    SARS-CoV-2
    Coronavirus
    Transplantation
    Solid organ transplantation
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/4154
    
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    DOI
    https://doi.org/10.1093/cid/ciaa1097
    Abstract
    Background: The coronavirus disease 2019 (COVID-19) pandemic has led to significant reductions in transplantation, motivated in part by concerns of disproportionately more severe disease among solid organ transplant (SOT) recipients. However, clinical features, outcomes, and predictors of mortality in SOT recipients are not well described. Methods: We performed a multicenter cohort study of SOT recipients with laboratory-confirmed COVID-19. Data were collected using standardized intake and 28-day follow-up electronic case report forms. Multivariable logistic regression was used to identify risk factors for the primary endpoint, 28-day mortality, among hospitalized patients. Results: Four hundred eighty-two SOT recipients from >50 transplant centers were included: 318 (66%) kidney or kidney/pancreas, 73 (15.1%) liver, 57 (11.8%) heart, and 30 (6.2%) lung. Median age was 58 (interquartile range [IQR] 46–57), median time post-transplant was 5 years (IQR 2–10), 61% were male, and 92% had ≥1 underlying comorbidity. Among those hospitalized (376 [78%]), 117 (31%) required mechanical ventilation, and 77 (20.5%) died by 28 days after diagnosis. Specific underlying comorbidities (age >65 [adjusted odds ratio [aOR] 3.0, 95% confidence interval [CI] 1.7–5.5, P < .001], congestive heart failure [aOR 3.2, 95% CI 1.4–7.0, P = .004], chronic lung disease [aOR 2.5, 95% CI 1.2–5.2, P = .018], obesity [aOR 1.9, 95% CI 1.0–3.4, P = .039]) and presenting findings (lymphopenia [aOR 1.9, 95% CI 1.1–3.5, P = .033], abnormal chest imaging [aOR 2.9, 95% CI 1.1–7.5, P = .027]) were independently associated with mortality. Multiple measures of immunosuppression intensity were not associated with mortality. Conclusions: Mortality among SOT recipients hospitalized for COVID-19 was 20.5%. Age and underlying comorbidities rather than immunosuppression intensity-related measures were major drivers of mortality.
    Citation
    Olivia S Kates, Brandy M Haydel, Sander S Florman, et. al. Coronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study, Clinical Infectious Diseases, , ciaa1097, https://doi.org/10.1093/cid/ciaa1097
    Citation to related work
    Oxford University Press
    Has part
    Clinical Infectious Diseases
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    ae974a485f413a2113503eed53cd6c53
    http://dx.doi.org/10.34944/dspace/4136
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