TY - JOUR
T1 - Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic
AU - the UW COVID-19 SOT Study Team
AU - Heldman, Madeleine R.
AU - Kates, Olivia S.
AU - Safa, Kassem
AU - Kotton, Camille N.
AU - Georgia, Sarah J.
AU - Steinbrink, Julie M.
AU - Alexander, Barbara D.
AU - Hemmersbach-Miller, Marion
AU - Blumberg, Emily A.
AU - Multani, Ashrit
AU - Haydel, Brandy
AU - La Hoz, Ricardo M.
AU - Moni, Lisset
AU - Condor, Yesabeli
AU - Flores, Sandra
AU - Munoz, Carlos G.
AU - Guitierrez, Juan
AU - Diaz, Esther I.
AU - Diaz, Daniela
AU - Vianna, Rodrigo
AU - Guerra, Giselle
AU - Loebe, Matthias
AU - Rakita, Robert M.
AU - Malinis, Maricar
AU - Azar, Marwan M.
AU - Hemmige, Vagish
AU - McCort, Margaret E.
AU - Chaudhry, Zohra S.
AU - Singh, Pooja P.
AU - Hughes Kramer, Kailey
AU - Velioglu, Arzu
AU - Yabu, Julie M.
AU - Morillis, Jose A.
AU - Mehta, Sapna A.
AU - Tanna, Sajal D.
AU - Ison, Michael G
AU - Derenge, Ariella C.
AU - van Duin, David
AU - Maximin, Adrienne
AU - Gilbert, Carlene
AU - Goldman, Jason D.
AU - Lease, Erika D.
AU - Fisher, Cynthia E.
AU - Limaye, Ajit P.
AU - De la Cruz, Oveimar
AU - Besharatian, Behdad D.
AU - Crespo, Maria
AU - Tomic, Rade
AU - Sehgal, Sameep
AU - Weisshaar, Dana
AU - Girgis, Reda
AU - Lawrence, Cameron
AU - Nelson, Joanna
AU - Bennett, William
AU - Leandro, Jennifer
AU - Sait, Afrah
AU - Rumore, Amy
AU - West, Patricia
AU - Jeng, Amy
AU - Bajrovic, Valida
AU - Bilgili, Erin P.
AU - Anderson-Haag, Tracy
AU - Nastase, Abigail
AU - Badami, Abbas
AU - Alvarez-Garcia, Jesus
AU - Bowman-Anger, Lyndsey
AU - Julien, Lovelyn
AU - Ortiz-Bautista, Carlos
AU - Friedman-Morocco, Rachel
AU - Gajurel, Kiran
AU - Cahuayme-Zuniga, Lizbeth
AU - Wakefield, Mark
AU - Fung, Monica
AU - Theodoropoulos, Nicole
AU - Chuang, Sally T.
AU - Bhandaram, Srividya
AU - Veroux, Massimiliano
AU - Chopra, Bhavna
AU - Florescu, Diana
AU - Witteck, Danielle
AU - Diaz, Daniela
AU - Ripley, Kathryn
AU - Saharia, Kapil
AU - Akkina, Sanjeev
AU - McCarty, Todd P.
AU - Webb, Ally
AU - Arya, Akanksha
AU - Vedula, Giridhar
AU - El-Amm, Jose Marie
AU - Katherine Dokus, M.
AU - Narayanan, Arun
AU - Cilene Leon Bueno de Camargo, Priscila
AU - Ouseph, Rosemary
AU - Breuckner, Andrew
AU - Luk, Alfred
AU - Aujayeb, Avinash
AU - Ganger, Daniel
AU - Keith, Douglas S.
AU - Meloni, Federica
AU - Haidar, Ghady
AU - Zapernick, Lori
AU - Moraels, Megan
AU - Goyal, Nitender
AU - Sharma, Tanvi
AU - Malhotra, Uma
AU - Kuo, Alexander
AU - Rossi, Ana P.
AU - Edwards, Angelina
AU - Keller, Brian
AU - Beneri, Christy
AU - Derringer, Darby
AU - Dominguez, Edward
AU - Carlson, Elise
AU - Hashim, Faris
AU - Murad, Haris
AU - Wilkens, Heinrike
AU - Neumann, Henry
AU - Gani, Imran
AU - Kahwaji, Joseph
AU - Popoola, Joyce
AU - Michaels, Marian
AU - Jakharia, Niyati
AU - Puing, Alfredo
AU - Motallebzadeh, Reza
AU - Velagapudi, Ravi
AU - Kapoor, Rajan
AU - Allam, Sridhar
AU - Silveira, Fernanda
AU - Vora, Surabhi
AU - Kelly, Ursala M.
AU - Reddy, Uttam
AU - Dharnidharka, Vikas
AU - Wadei, Hani
AU - Zurabi, Lominadze
N1 - Publisher Copyright:
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2022/1
Y1 - 2022/1
N2 - 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. (Figure presented.).
AB - 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. (Figure presented.).
UR - http://www.scopus.com/inward/record.url?scp=85116741123&partnerID=8YFLogxK
U2 - 10.1111/ajt.16840
DO - 10.1111/ajt.16840
M3 - Article
C2 - 34514710
AN - SCOPUS:85116741123
SN - 1600-6135
VL - 22
SP - 279
EP - 288
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 1
ER -