General and Intensive Care Outcomes for Hospitalized Patients With Solid Organ Transplants With COVID-19.

Fiore Mastroianni,Daniel E Leisman,Grace Fisler,Mangala Narasimhan

doi:10.1177/0885066620965163

Abstract

Purpose:COVID-19 has been associated with a dysregulated inflammatory response. Patients who have received solid-organ transplants are more susceptible to infections in general due to the use of immunosuppressants. We investigated factors associated with mechanical ventilation and outcomes in solid-organ transplant recipients with COVID-19.Materials and Methods:We conducted a retrospective cohort study of all solid-organ transplant recipients admitted with a diagnosis of COVID-19 in our 23-hospital health system over a 1-month period. Descriptive statistics were used to describe hospital course and laboratory results and bivariate comparisons were performed on variables to determine differences.Results:Twenty-two patients with solid-organ transplants and COVID-19 were identified. Eight patients were admitted to the ICU, of which 7 were intubated. Admission values of CRP (p = 0.045) and N/L ratio (p = 0.047) were associated with the need for mechanical ventilation. Seven patients (32%) died during admission, including 86% (n = 6) of patients who received mechanical ventilation.Conclusions:In solid-organ transplant recipients with COVID-19, initial CRP and N/L ratio were associated with need for mechanical ventilation.

Highlights

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), continues to spread rapidly throughout the world
General Characteristics of Solid Organ Transplant Recipients Admitted for COVID-19
Thirty-six percent (n 1⁄4 8) patients were admitted to the Intensive Care Unit (ICU) and the remaining 64% (n 1⁄4 14) were managed on the general inpatient floors

Summary

Introduction

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), continues to spread rapidly throughout the world. Much remains unknown about the effects of SARS-Cov-2 on organ function and the host response. The pathogenesis of COVID-19 induced organ dysfunction has been associated with evidence of a dysregulated immune system.[1] Given that organ transplant recipients receive chronic immunosuppression, studying the course of disease and factors that associate with illness severity in this population may yield important observations. Literature describing COVID-19 in this population has grown since the pandemic began. This report will describe factors that are associated with critical illness in this population

Objectives

Methods

Results

Discussion

Conclusion