Department of Medicine, Division of Infectious Disease, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Lung Transplant Program, Division of Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Transpl Infect Dis. 2021 Aug;23(4):e13637. doi: 10.1111/tid.13637. Epub 2021 May 31.
Whether solid organ transplant (SOT) recipients are at increased risk of poor outcomes due to COVID-19 in comparison to the general population remains uncertain. In this study, we compared outcomes of SOT recipients and non-SOT patients hospitalized with COVID-19 in a propensity score matched analysis based on age, race, ethnicity, BMI, diabetes, and hypertension. After propensity matching, 117 SOT recipients and 350 non-SOT patients were evaluated. The median age of SOT recipients was 61 years, with a median time from transplant of 5.68 years. The most common transplanted organs were kidney (48%), followed by lung (21%), heart (19%), and liver (10%). Overall, SOT recipients were more likely to receive COVID-19 specific therapies and to require ICU admission. However, mortality (23.08% in SOT recipients vs. 23.14% in controls, P = .21) and highest level of supplemental oxygen (P = .32) required during hospitalization did not significantly differ between groups. In this propensity matched cohort study, SOT recipients hospitalized with COVID-19 had similar overall outcomes as non-SOT recipients, suggesting that chronic immunosuppression may not be an independent risk factor for poor outcomes in COVID-19.
实体器官移植（SOT）受者与普通人群相比，COVID-19 是否有更高的不良结局风险仍不确定。在这项研究中，我们基于年龄、种族、民族、BMI、糖尿病和高血压，在倾向评分匹配分析中比较了 SOT 受者和 COVID-19 住院非 SOT 患者的结局。在倾向评分匹配后，评估了 117 名 SOT 受者和 350 名非 SOT 患者。SOT 受者的中位年龄为 61 岁，移植后中位时间为 5.68 年。最常见的移植器官是肾脏（48%），其次是肺（21%）、心脏（19%）和肝脏（10%）。总体而言，SOT 受者更有可能接受 COVID-19 特异性治疗和需要入住 ICU。然而，两组患者的死亡率（SOT 受者为 23.08%，对照组为 23.14%，P=0.21）和住院期间需要的最高吸氧水平（P=0.32）无显著差异。在这项倾向评分匹配的队列研究中，COVID-19 住院的 SOT 受者与非 SOT 受者的总体结局相似，这表明慢性免疫抑制可能不是 COVID-19 不良结局的独立危险因素。
