Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic.

dc.contributor.author

Heldman, Madeleine R

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Kates, Olivia S

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Safa, Kassem

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Kotton, Camille N

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Georgia, Sarah J

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Steinbrink, Julie M

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Alexander, Barbara D

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Hemmersbach-Miller, Marion

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Blumberg, Emily A

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Multani, Ashrit

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Haydel, Brandy

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La Hoz, Ricardo M

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Moni, Lisset

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Condor, Yesabeli

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Flores, Sandra

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Munoz, Carlos G

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Guitierrez, Juan

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Diaz, Esther I

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Diaz, Daniela

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Vianna, Rodrigo

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Guerra, Giselle

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Loebe, Matthias

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Rakita, Robert M

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Malinis, Maricar

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Azar, Marwan M

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Hemmige, Vagish

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McCort, Margaret E

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Chaudhry, Zohra S

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Singh, Pooja P

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Hughes Kramer, Kailey

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Velioglu, Arzu

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Yabu, Julie M

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Morillis, Jose A

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Mehta, Sapna A

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Tanna, Sajal D

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Ison, Michael G

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Derenge, Ariella C

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van Duin, David

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Maximin, Adrienne

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Gilbert, Carlene

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Goldman, Jason D

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Lease, Erika D

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Fisher, Cynthia E

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Limaye, Ajit P

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UW COVID-19 SOT Study Team

dc.date.accessioned

2022-10-03T11:04:10Z

dc.date.available

2022-10-03T11:04:10Z

dc.date.issued

2022-01

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2022-10-03T11:04:09Z

dc.description.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.

dc.identifier.issn

1600-6135

dc.identifier.issn

1600-6143

dc.identifier.uri

https://hdl.handle.net/10161/26025

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

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10.1111/ajt.16840

dc.subject

UW COVID-19 SOT Study Team

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Humans

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Organ Transplantation

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Pandemics

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Transplant Recipients

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COVID-19

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SARS-CoV-2

dc.title

Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic.

dc.type

Journal article

duke.contributor.orcid

Heldman, Madeleine R|0000-0002-9424-1870

duke.contributor.orcid

Steinbrink, Julie M|0000-0003-0771-3647

duke.contributor.orcid

Alexander, Barbara D|0000-0001-5868-0529

pubs.begin-page

279

pubs.end-page

288

pubs.issue

1

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Medicine

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Pathology

pubs.organisational-group

Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

22

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