Longitudinal Outcomes of COVID-19 in Solid Organ Transplant Recipients from 2020 to 2023.

Longitudinal Outcomes of COVID-19 in Solid Organ Transplant Recipients from 2020 to 2023.

Publication date: Mar 16, 2024

Data regarding COVID-19 outcomes in solid organ transplant recipients(SOTr) across SARS-CoV-2 waves, including the impact of different measures, is lacking. This cohort study, conducted from March 2020-May 2023 in Toronto, Canada, aimed to analyze COVID-19 outcomes in 1,975 SOTr across various SARS-CoV-2 waves and assess the impact of preventive and treatment measures. The primary outcome was severe COVID-19, defined as requiring supplemental oxygen, with secondary outcomes including hospitalization, length of stay, ICU admission, and 30-day and 1-year all-cause mortality. SARS-CoV-2 waves were categorized as Wildtype/Alpha/Delta(318 cases, 16. 1%), Omicron-BA. 1(268, 26. 2%), Omicron-BA. 2(268, 13. 6%), Omicron-BA. 5(561, 28. 4%), Omicron-BQ. 1.1(188, 9. 5%), and Omicron-XBB. 1.5(123, 6. 2%). Severe COVID-19 rate was highest during the Wildtype/Alpha/Delta wave(44. 6%), and lower in Omicron waves(5. 7-16. 1%). Lung transplantation was associated with severe COVID-19(OR:4. 62, 95%CI:2. 71-7. 89), along with rituximab treatment(OR:4. 24, 95%CI:1. 04-17. 3), long-term corticosteroid use(OR:3. 11, 95%CI:1. 46-6. 62), older age(OR: 1. 51, 95%CI:1. 30-1. 76), chronic lung disease(OR:2. 11, 95%CI:1. 36-3. 30), chronic kidney disease(OR:2. 18, 95%CI:1. 17-4. 07), and diabetes(OR:1. 97, 95%CI:1. 37-2. 83). Early treatment and ≥3 vaccine doses were associated with reduced severity(OR: 0. 29, 95%CI:0. 19-0. 46, and 0. 35, 95%CI:0. 21-0. 60, respectively). Tixagevimab/cilgavimab and bivalent boosters did not show a significant impact. The study concludes that COVID-19 severity decreased across different variants in SOTr. Lung transplantation was associated with worse outcomes and may benefit more from preventive and early therapeutic interventions.

Concepts Keywords
Canada Ba
Hospitalization Ci
Kidney Cov


Type Source Name
drug DRUGBANK Rituximab
drug DRUGBANK Oxygen
disease VO Canada
disease MESH COVID-19
disease MESH Long Covid
disease VO vaccine
disease MESH chronic kidney disease

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