COVID-19 Reinfection Has Better Outcomes Than the First Infection in Solid Organ Transplant Recipients.

Publication date: Jan 31, 2024

Solid organ transplant recipients face an increased risk of severe coronavirus disease 2019 (COVID-19) and are vulnerable to repeat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. In nonimmunocompromised individuals, SARS-CoV-2 reinfections are milder likely because of cross-protective immunity. We sought to determine whether SARS-CoV-2 reinfection exhibits milder manifestations than primary infection in transplant recipients. Using a large, prospective cohort of adult transplant patients with COVID-19, we identified patients with SARS-CoV-2 reinfections. We performed a 1:1 nearest neighbor propensity score matching to control potential confounders, including the COVID-19 variant. We compared outcomes including oxygen requirement, hospitalization, and intensive care unit admission within 30 d after diagnosis between patients with reinfection and those with the first episode of COVID-19. Between 2020 and 2023, 103 reinfections were identified in a cohort of 1869 transplant recipients infected with SARS-CoV-2 (incidence of 2. 7% per year). These included 50 kidney (48. 5%), 27 lung (26. 2%), 7 heart (6. 8%), 6 liver (5. 8%), and 13 multiorgan (12. 6%) transplants. The median age was 54. 5 y (interquartile range [IQR], 40. 5-65. 5) and the median time from transplant to first infection was 6. 6 y (IQR, 2. 8-11. 2). The time between the primary COVID-19 and reinfection was 326 d (IQR, 226-434). Three doses or more of SARS-CoV-2 vaccine are received by 87. 4% of patients. After propensity score matching, reinfections were associated with significantly lower hospitalization (5. 8% versus 19. 4%; risk ratio, 0. 3; 95% CI, 0. 12-0. 71) and oxygen requirement (3. 9% versus 13. 6%; risk ratio, 0. 29; 95% CI, 0. 10-0. 84). In a within-patient analysis only in the reinfection group, the second infection was milder than the first (3. 9% required oxygen versus 19. 4%, P 

Concepts Keywords
Coronavirus Cov
Hospitalization Covid
Increased Infection
Kidney Iqr


Type Source Name
disease MESH COVID-19
disease MESH Reinfection
drug DRUGBANK Tropicamide
disease MESH Infection
disease VO Severe acute respiratory syndrome coronavirus 2
disease IDO primary infection
drug DRUGBANK Oxygen
disease VO time
disease VO vaccine

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