Darılmaz Yüce Gülbahar, Ulubay Gaye, Tek Korhan, Savaş Bozbaş Şerife, Erol Çiğdem, Büyükaşık Pırıl, Haberal Kemal Murat, Arslan Ayşe Hande, Akçay Müşerref Şule, Haberal Mehmet
From the Department of Pulmonary Diseases Başkent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2023 May;21(5):451-459. doi: 10.6002/ect.2021.0361. Epub 2021 Oct 11.
The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey.
Our study included 23 solidorgan transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P <.05 was considered statistically significant.
Mean age of solid-organ transplant recipients was 49.8 ± 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P = .224). Transplant recipients had greater requirements for nasal oxygen (P = .005) and noninvasive mechanical ventilation (P = .003) and had longer length of intensive care unit stay (P = .030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P = .439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P <.05). Secondary infections were major causes of mortality in transplant recipients.
COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.
实体器官移植受者感染新型冠状病毒肺炎（COVID-19）的临床特征、治疗方法、结局及死亡预测因素尚未明确。本研究调查了土耳其我们中心实体器官移植受者感染COVID-19的临床特征。
我们的研究纳入了2020年3月至2021年1月期间因COVID-19疾病在我院住院的23名实体器官移植受者和336名非移植个体（143名既往健康者和193名至少合并一种疾病的患者）。比较了患者的人口统计学、临床和实验室数据。我们使用SPSS 20.0版进行统计分析。所有组均采用卡方检验和曼-惠特尼U检验进行比较。P<0.05被认为具有统计学意义。
实体器官移植受者的平均年龄为49.8±13.7岁（男性占78.3%，女性占21.7%）。在23名受者中，17名（73.9%）为肾移植受者，6名（26.1%）为肝移植受者。在非移植个体中，88.7%（n=298）患有轻/中度疾病，11.3%（n=38）患有重度疾病。在移植受者中，78.3%（n=18）患有轻/中度疾病，21.7%（n=5）患有重度疾病（P=0.224）。与非移植个体相比，移植受者对鼻导管吸氧（P=0.005）和无创机械通气的需求更大（P=0.003），重症监护病房住院时间更长（P=0.030）。两组在死亡率方面无差异（P=0.439）。然而，亚组分析显示，与既往健康的COVID-19患者相比，移植受者的死亡率更高（P<0.05）。继发感染是移植受者死亡的主要原因。
与健康患者相比，COVID-19感染导致实体器官移植受者的死亡率更高。移植受者需要更多关注继发感染以降低死亡率。
