COVID-19 in solid organ transplant recipients: No difference in survival compared to general population

Coronavirus disease 2019 (COVID-19) may be associated with worse outcome in solid organ transplant (SOT) recipients. We performed a prospective cohort study of hospitalized patients with confirmed diagnosis of COVID-19, from March 15 to April 30, 2020, at two tertiary hospitals in Emilia-Romagna Region. SOT recipients were compared with non-SOT patients. Primary endpoint was all-cause 30-day mortality. Relationship between SOT status and mortality was investigated by univariable and multivariable Cox regression analysis. Patients were assessed from COVID-19 diagnosis to death or 30-day whichever occurred first. Study cohort consisted of 885 patients, of them 24 SOT recipients (n = 22, kidney, n = 2 liver). SOT recipients were younger, had lower BMI, but higher Charlson Index. At admission they presented less frequently with fever and respiratory failure. No difference in 30-day mortality between the two groups (19% vs 22.1%) was found; however, there was a trend toward higher rate of respiratory failure (50% vs 33.1%,P = .07) in SOT recipients. Superinfections were more represented in SOT recipients, (50% vs 15.5%,P < .001). At multivariate analysis adjusted for main covariates, there was no association between SOT and 30-day mortality HR 1.15 (95% CI 0.39-3.35)P = .79. Our data suggest that mortality among COVID-19 SOT recipients is similar to general population.

Automated summary

This study compared SOT recipients and non-SOT patients with COVID-19 and found that the 30-day mortality rate among SOT recipients was similar to non-SOT patients, but with higher rates of respiratory failure and superinfections.