Department of Infectious Diseases, Hospital Clinic - IDIBAPS, ISGlobal (Institute for Global Health), University of Barcelona, Barcelona, Spain.
Department of Nephrology and Renal Transplantation, Hospital Clinic - IDIBAPS, ISGlobal (Institute for Global Health), University of Barcelona, Barcelona, Spain.
PLoS One. 2021 Mar 3;16(3):e0247251. doi: 10.1371/journal.pone.0247251. eCollection 2021.
In the context of COVID-19 pandemic, we aimed to analyze the epidemiology, clinical characteristics, risk factors for mortality and impact of COVID-19 on outcomes of solid organ transplant (SOT) recipients compared to a cohort of non transplant patients, evaluating if transplantation could be considered a risk factor for mortality. From March to May 2020, 261 hospitalized patients with COVID-19 pneumonia were evaluated, including 41 SOT recipients. Of these, thirty-two were kidney recipients, 4 liver, 3 heart and 2 combined kidney-liver transplants. Median time from transplantation to COVID-19 diagnosis was 6 years. Thirteen SOT recipients (32%) required Intensive Care Unit (ICU) admission and 5 patients died (12%). Using a propensity score match analysis, we found no significant differences between SOT recipients and non-transplant patients. Older age (OR 1.142; 95% [CI 1.08-1.197]) higher levels of C-reactive protein (OR 3.068; 95% [CI 1.22-7.71]) and levels of serum creatinine on admission (OR 3.048 95% [CI 1.22-7.57]) were associated with higher mortality. The clinical outcomes of SARS-CoV-2 infection in our cohort of SOT recipients appear to be similar to that observed in the non-transplant population. Older age, higher levels of C-reactive protein and serum creatinine were associated with higher mortality, whereas SOT was not associated with worse outcomes.
在 COVID-19 大流行的背景下，我们旨在分析流行病学、临床特征、死亡率的危险因素以及 COVID-19 对实体器官移植（SOT）受者与非移植患者的结局的影响，评估移植是否可被视为死亡率的危险因素。2020 年 3 月至 5 月，共评估了 261 例 COVID-19 肺炎住院患者，其中包括 41 例 SOT 受者。其中，32 例为肾移植受者，4 例为肝移植受者，3 例为心脏移植受者，2 例为肝肾联合移植受者。从移植到 COVID-19 诊断的中位时间为 6 年。32%的 SOT 受者（13 例）需要入住重症监护病房（ICU），5 例死亡（12%）。通过倾向评分匹配分析，我们发现 SOT 受者与非移植患者之间无显著差异。年龄较大（OR 1.142；95%CI 1.08-1.197）、C 反应蛋白水平较高（OR 3.068；95%CI 1.22-7.71）和入院时血清肌酐水平较高（OR 3.048 95%CI 1.22-7.57）与更高的死亡率相关。我们的 SOT 受者队列中 SARS-CoV-2 感染的临床结局似乎与非移植人群观察到的相似。年龄较大、C 反应蛋白和血清肌酐水平较高与死亡率升高相关，而 SOT 与结局恶化无关。
