COVID-19 in solid organ transplant recipients: A national cohort study from Sweden

Autor: Emily de Coursey, Marie Felldin, John Mackay Søfteland, Susannah Leach, Jesper Magnusson, Gustav Friman, Bengt von Zur-Mühlen, Ali Reza Biglarnia, Hanna Jacobsson, Kristjan Karason, Ida Löfman, Vanda Friman, Andreas Schult, Bo-Göran Ericzon, Carin Wallquist, Per Lindnér, Mihai Oltean, Jan Ekelund, Jan-Åke Liljeqvist
Rok vydání: 2021
Předmět:
Male
immunosuppressant
Patient characteristics
Infektionsmedicin
Cohort Studies
infection and infectious agents ‐ viral
Seroepidemiologic Studies
clinical research / practice
Immunology and Allergy
organ transplantation in general
Pharmacology (medical)
patient characteristics
dysfunction
Middle Aged
Early warning score
practice
infection and infectious agents ‐
Original Article
medicine.symptom
viral
Infectious Medicine
medicine.medical_specialty
kidney (allograft) function
Coronavirus disease 2019 (COVID-19)
infectious disease
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Renal function
Asymptomatic
patient survival
Internal medicine
medicine
Humans
Seroprevalence
Aged
Retrospective Studies
Sweden
Transplantation
kidney (allograft) function / dysfunction
SARS-CoV-2
business.industry
Kirurgi
COVID-19
Original Articles
Organ Transplantation
health services and outcomes research
Transplant Recipients
clinical research
Surgery
Solid organ transplantation
business
Zdroj: American Journal of Transplantation
ISSN: 1600-6135
DOI: 10.1111/ajt.16596
Popis: Solid organ transplant (SOT) recipients run a high risk for adverse outcomes from COVID-19, with reported mortality around 19%. We retrospectively reviewed all known Swedish SOT recipients with RT-PCR confirmed COVID-19 between March 1 and November 20, 2020 and analyzed patient characteristics, management, and outcome. We identified 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%). Most patients were hospitalized (64%), but 36% remained outpatients. Age >50 and male sex were among predictors of transition from outpatient to inpatient status. National early warning Score 2 (NEWS2) at presentation was higher in non-survivors. Thirty-day all-cause mortality was 9.6% (15.0% for inpatients), increased with age and BMI, and was higher in men. Renal function decreased during COVID-19 but recovered in most patients. SARS-CoV-2 antibodies were identified in 78% of patients at 1-2 months post-infection. Nucleocapsid-specific antibodies decreased to 38% after 6-7 months, while spike-specific antibody responses were more durable. Seroprevalence in 559 asymptomatic patients was 1.4%. Many patients can be managed on an outpatient basis aided by risk stratification with age, sex, and NEWS2 score. Factors associated with adverse outcomes include older age, male sex, greater BMI, and a higher NEWS2 score.
Databáze: OpenAIRE
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