Abstract
Mortality among patients hospitalized for COVID-19 has declined over the course of the pandemic. Mortality trends specifically in solid organ transplant recipients (SOTR) are unknown. Using data from a multicenter registry of SOTR hospitalized for COVID-19, we compared 28-day mortality between early 2020 (March 1, 2020–June 19, 2020) and late 2020 (June 20, 2020–December 31, 2020). Multivariable logistic regression was used to assess comorbidity-adjusted mortality. Time period of diagnosis was available for 1435/1616 (88.8%) SOTR and 971/1435 (67.7%) were hospitalized: 571/753 (75.8%) in early 2020 and 402/682 (58.9%) in late 2020 (p <.001). Crude 28-day mortality decreased between the early and late periods (112/571 [19.6%] vs. 55/402 [13.7%]) and remained lower in the late period even after adjusting for baseline comorbidities (aOR 0.67, 95% CI 0.46–0.98, p =.016). Between the early and late periods, the use of corticosteroids (≥6 mg dexamethasone/day) and remdesivir increased (62/571 [10.9%] vs. 243/402 [61.5%], p <.001 and 50/571 [8.8%] vs. 213/402 [52.2%], p <.001, respectively), and the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitor decreased (329/571 [60.0%] vs. 4/492 [1.0%], p <.001 and 73/571 [12.8%] vs. 5/402 [1.2%], p <.001, respectively). Mortality among SOTR hospitalized for COVID-19 declined between early and late 2020, consistent with trends reported in the general population. The mechanism(s) underlying improved survival require further study. (Figure presented.).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 279-288 |
| Number of pages | 10 |
| Journal | American Journal of Transplantation |
| Volume | 22 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2022 |
Funding
This work was supported by the National Institute of Allergy and Infectious Diseases (T32AI118690 to M.R.H. and O.S.K.) and the National Heart, Lung, and Blood Institute (HL143050 to C.E.F.) at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The following are the members of the UW COVID-19 SOT Study Team, without whom this work would not have been possible: Behdad D. Besharatian MD, Maria Crespo MD, Rade Tomic MD, Sameep Sehgal MD, Dana Weisshaar MD, Reda Girgis MD, Cameron Lawrence BS, Joanna Nelson MD, William Bennett MD, Jennifer Leandro, Afrah Sait MD, Amy Rumore PharmD, Patricia West PhD, Amy Jeng MD, Valida Bajrovic MD, Erin P. Bilgili BS, Tracy Anderson-Haag PharmD, BCPS, Abigail Nastase, Abbas Badami MD, Jesus Alvarez-Garcia MD, Lyndsey Bowman-Anger PharmD, Lovelyn Julien MPH, Carlos Ortiz-Bautista MD, Rachel Friedman-Morocco MD, Kiran Gajurel MD, Lizbeth Cahuayme-Zuniga MD, Mark Wakefield MD, Monica Fung MD, Nicole Theodoropoulos MD, MS, Sally T. Chuang MD, Srividya Bhandaram MD, Massimiliano Veroux MD, PhD, Bhavna Chopra MD, Diana Florescu MD, Danielle Witteck, Daniela Diaz, Kathryn Ripley, NP-C, Kapil Saharia MD, MPH, Sanjeev Akkina MD, Todd P. McCarty MD, Ally Webb PharmD, Akanksha Arya MD, Giridhar Vedula MD, Jose-Marie El-Amm MD, M. Katherine Dokus, Arun Narayanan MD, Priscila Cilene Leon Bueno de Camargo MD, Rosemary Ouseph MD, Andrew Breuckner PharmD, Alfred Luk MD, Avinash Aujayeb MBBS, MRCP, Daniel Ganger MD, Douglas S. Keith MD, Federica Meloni MD, Ghady Haidar MD, Lori Zapernick, Megan Moraels MD, Nitender Goyal MD, Tanvi Sharma MD, MPH, Uma Malhotra MD, Alexander Kuo MD, Ana P. Rossi MD, MPH, Angelina Edwards MD, Brian Keller MD, PhD, Christy Beneri DO, Darby Derringer PharmD, Edward Dominguez MD, Elise Carlson PharmD, Faris Hashim MD, Haris Murad MD, Heinrike Wilkens MD, Henry Neumann MD, Imran Gani MD, Joseph Kahwaji MD, Joyce Popoola FRCP, Marian Michaels MD, MPH, Niyati Jakharia MD, Oveimar De la Cruz MD, Alfredo Puing MD, Reza Motallebzadeh, Ravi Velagapudi MD, Rajan Kapoor MD, Sridhar Allam MD, Fernanda Silveira MD, Surabhi Vora MD, MPH, Ursala M. Kelly MD, Uttam Reddy MD, Vikas Dharnidharka MD, MPH, Hani Wadei MD, and Lominadze Zurabi MD. This work was supported by the National Institute of Allergy and Infectious Diseases (T32AI118690 to M.R.H. and O.S.K.) and the National Heart, Lung, and Blood Institute (HL143050 to C.E.F.) at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)
