Excess mortality in solid organ transplant recipients hospitalized with COVID-19: A large-scale comparison of SOT recipients hospitalized with or without COVID-19
Excess mortality in solid organ transplant recipients hospitalized with COVID-19: A large-scale comparison of SOT recipients hospitalized with or without COVID-19
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DOI：
10.1111/ctr.14492
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发表时间：
2021-10-01
影响因子：
2.1
通讯作者：
Solomon, Scott D.
中科院分区：
文献类型：
--
作者：
Jering, Karola S.;McGrath, Martina M.;Solomon, Scott D.
背景与普通人群相比，患有2019冠状病毒病（COVID-19）的实体器官移植（SOT）接受者发生不良结局的风险更高。患有COVID-19的住院SOT接受者的死亡风险是否高于因其他原因（包括非COVID-19肺炎）住院的SOT接受者，目前尚不清楚。方法我们使用logistic回归比较SOT接受者因COVID-19住院与非COVID-19相关入院和非COVID-19肺炎的结局。结果在17，012名住院SOT接受者中，1682人患有COVID-19。COVID-19患者入住ICU（调整后的比值比[aOR] 2.12 [95%CI：1.88-2.39]）和机械通气（aOR 3.75 [95%CI：3.24-4.33]）的几率更高。COVID-19与院内死亡几率较高相关，这在大流行早期更为明显（2020年4月/5月的aOR 9.74 [95%CI：7.08-13.39] vs. 6月至11月的aOR 7.08 [95%CI：5.62-8.93]; P-交互作用= 0.03）。与因非COVID-19肺炎住院的SOT接受者相比，无论住院时间如何，COVID-19 SOT接受者的院内死亡几率均较高（aOR 2.44 [95%CI：1.90-3.13]）（P-交互作用> 0.40）。结论在这个大型SOT接受者队列中，与非COVID-19相关入院相比，COVID-19住院与并发症和住院死亡率的几率更高相关，与非COVID-19肺炎的SOT接受者相比，住院死亡率的几率高出2.5倍。
Background Solid-organ transplant (SOT) recipients with coronavirus disease 2019 (COVID-19) have higher risk of adverse outcomes compared to the general population. Whether hospitalized SOT recipients with COVID-19 are at higher risk of mortality than SOT recipients hospitalized for other causes, including non-COVID-19 pneumonia, remains unclear. Methods We used logistic regression to compare outcomes of SOT recipients hospitalized with COVID-19 to non-COVID-19 related admissions and with non-COVID-19 pneumonia. Results Of 17,012 hospitalized SOT recipients, 1682 had COVID-19. Those with COVID-19 had higher odds of ICU admission (adjusted odds ratio [aOR] 2.12 [95%CI: 1.88-2.39]) and mechanical ventilation (aOR 3.75 [95%CI: 3.24-4.33]). COVID-19 was associated with higher odds of in-hospital death, which was more pronounced earlier in the pandemic (aOR 9.74 [95%CI: 7.08-13.39] for April/May vs. aOR 7.08 [95%CI: 5.62-8.93] for June through November 2020; P-interaction = .03). Compared to SOT recipients hospitalized with non-COVID-19 pneumonia, odds of in-hospital death were higher in SOT recipients with COVID-19 (aOR 2.44 [95% CI: 1.90-3.13]), regardless of time of hospitalization (P-interaction > .40). Conclusions In this large cohort of SOT recipients, hospitalization with COVID-19 was associated with higher odds of complications and in-hospital mortality than non-COVID-19 related admissions, and 2.5-fold higher odds of in-hospital mortality, compared to SOT recipients with non-COVID-19 pneumonia.