Investigators who reviewed data from the largest cohort to date of solid organ transplant (SOT) recipients with COVID-19 found that the viral illness is more likely to occur among those who receive kidney rather than other solid organs, according to a presentation at the virtual 2021 American Transplant Congress.

Of 19,031 SOT recipients tested for COVID-19 from January 1 to November 23, 2020, 2183 (11.5%) tested positive and 16,848 tested negative for SARS-CoV-2, the novel coronavirus that causes it, Gaurav Agarwal, MD, of the University of Alabama at Birmingham, and colleagues reported. Kidney transplant recipients had the highest positivity rate: 71.8%.

The study also looked at risk factors associated with SARS-CoV-2 infection. Compared with patients who tested negative, those who tested positive were significantly more likely to have hypertension (86.7% vs 81.1%), diabetes (64.5% vs 59.0%), coronary artery disease (71.2% vs 67.6%), chronic kidney disease (76.3% vs 70.2%), and peripheral vascular disease (28.5% vs 23.2%), Dr Agarwal’s team reported. Chronic obstructive pulmonary disease or asthma were not risk factors. White SOT recipients were less likely than other races to test positive: They made up 47.3% of recipients who tested positive and 65.3% of those who tested negative.

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Following COVID-19 diagnosis, 51.9% of patients required hospitalization, 13.7% experienced major adverse cardiac events, 3.8% had graft rejection, and 3.4% had graft loss during the study period, according to the investigators.

The patients, who were part of the National COVID Cohort Collaborative (N3C), had a median follow-up time of 119 days. Of the 19,031 patients, 11,197 (58.8%) were male and 12,033 (63.2%) were White.


Agarwal G, Vinson A, Dai R, et al. Covid-19 in solid organ transplantation (SOT): results of the National Covid Cohort Collaborative (N3C). Presented at: ATC 2021 held June 4-9, 2021. Abstract 126.