Among patients hospitalized with COVID-19, solid organ transplant (SOT) recipients differ from other patients in their risk factors for ICU admission and death, according to study findings presented at the 2022 American Transplant Congress (ATC 2022) in Boston, Massachusetts.

Among many comorbidities examined in the study, only cardiac disease was significantly associated with ICU admission among SOT recipients, whereas cardiac disease, age, diabetes, neurologic disease, obesity, and hepatobiliary disease were significantly associated with ICU admission among patients with no history of SOT, Joanna Schaenman, MD, PhD, of the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), and colleagues reported in a poster presentation.

Factors significantly associated with death included neurologic conditions, heart disease, and lung disease in the SOT group and age, neurologic conditions, chronic kidney disease, and heart disease in the no-SOT group.

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The study compared 129 SOT recipients and 708 patients with no history of SOT admitted to the UCLA medical center. The SOT group had a significantly higher proportion of patients of Hispanic ethnicity (63.6% vs 39.4%), diabetes (62.8% vs 32.1%), cardiovascular disease (51.9% vs 25.6%), and lung disease (40.3% vs 20.8%) and a significantly lower proportion of obese patients (29.8% vs 41.4%).

“We should not assume that all demographic or clinical predictors of adverse clinical outcomes reported in the literature will apply equally to SOT patients,” the authors concluded. “These findings have implications for development of SOT-specific approaches for risk stratification that may be applied to patient evaluation and triage.”

Dr Schaenman and colleagues recently published study findings in Transplant Infectious Disease demonstrating that transplant status is important in predicting adverse clinical outcomes among patients hospitalized or admitted to an ICU with COVID-19. Data showed that non-kidney SOT (NKSOT) recipients had a higher death rate than kidney SOT recipients and those without an SOT (16.2% vs 1.8% and 8.3%, respectively). Among ICU patients, the NKSOT group had a nearly 3-fold increased risk for death compared with the no-SOT group.

References

Schaenman J, Byford H, Grogan T, et al. Risk factors associated with ICU admission and death in patients hospitalized with COVID-19 differ between solid organ transplant and non-solid organ transplant recipients. Presented at: ATC 2022, June 4-8, 2022, Boston, Massachusetts. Abstract 685

Schaenman J, Byford H, Grogan T, et al. Impact of solid organ transplant status on outcomes of hospitalized patients with COVID-19 infection. Transpl Infect Dis. Published online May 17, 2022. doi:10.1111/tid.13853