A Report of 85 Cases of COVID-19 and Abdominal Transplantation From a Single Center: What Are the Associated Factors With Death Among Organ Transplantation Patients.

BACKGROUND: In this study we report the epidemiology of COVID-19 among recipients of organ transplantation and evaluate associated factors with death. METHODS: We screened 6969 patients who had organ transplantations in our center for COVID-19. Specific data on presentation, clinical course, treatment and prognosis was acquired. RESULTS: We found 85 patients (66 liver, 16 kidney, 2 kidney-pancreas and 1 liver-kidney recipient) who acquired COVID-19. Most common symptoms included fever (48.2%), cough (41.2%), myalgia (41.2%), and fatigue (40%). Dyspnea developed in 33% of patients. Overall, one-third of patients had an oxygen saturation of bellow 90% on admission. Patients were hospitalized for a median (IQR) of 9 (5, 13.7) days and had a 33.9% ICU admission rate. Overall, 17 patients (20%) died which included 31.3% of patients with kidney transplantations and 21.9% of patients with liver transplantations.All 4 pediatric patients in our series died. In our univariate analysis among adults, rates of leukopenia (38.4% vs. 13.2%; p=0.04), low albumin levels (53.8% vs. 10.2%; p=0.001), and shorter duration between transplantation and COVID-19 (p=0.02), were higher among patients who died.In our LASSO regression model, low albumin levels (OR: 4.48, 95% CI= 1.16-17.27) were associated with higher risk of death. CONCLUSION: This is the largest single-center report on abdominal transplantations and COVID-19. Liver and kidney transplant recipients have an increased risk of mortality compared to the general population due to COVID-19. More specifically, pediatric patients and those with low albumin levels are at higher risks of death due COVID-19.