SARS-CoV-2 infection in solid organ transplant recipients: A retrospective cohort study

Purpose: Initial studies of COVID-19 in solid organ transplant (SOT) recipients demonstrated high mortality rates, but more recent comparative data shows contradictory results. Methods: We evaluated differences in demographic characteristics, comorbidities, clinical presentation, and outcomes among three patient groups based on their solid organ transplant status and COVID-19 status between 3/1/2020 and 6/30/2020: SOT recipients with COVID-19 (T+;C+), SOT recipients who tested negative for COVID-19 (T+;C-), patients with cirrhosis or end-stage renal disease (ESRD) who were positive for COVID-19 (T-;C+). Controls (T-;C+) were chosen in a 2:1 match with cases (T+;C+) based on age range, gender and testing date. Bivariate analyses were done using chi-square and Fisher's exact test for categorical data and ANOVA for continuous data using STATA 15. Bonferroni correction was applied for multiple comparison. Results: A total of 222 patients were included in this analysis, 22 (10%) T+;C+, 153 (69%) T+;C-, 47 (21%) T-;C+ (Table 1). Among transplant recipients, patients with COVID-19 were more likely non-Hispanic Black or Hispanic and younger. T+;C+ patients were more likely to present with symptoms than other groups;however, they were less likely to be hospitalized and die (p < 0.01). Among patients with COVID-19, patients with transplant were less likely to require supplemental oxygen support (p = 0.01) and ICU admission (p = 0.05). SARS-CoV-2 PCR cycle thresholds are shown in Figure 1. Conclusions: Patients who are transplant recipients with COVID-19 may not have a higher risk of severe disease or mortality in comparison to transplant patients without COVID-19 and patients with cirrhosis or ESRD. (Table Presented).