COVID-19 Among Solid Organ Transplant Recipients

Background In this study, we present the clinical characteristics and outcome of COVID-19 among solid organ transplant (SOT) recipients and assess factors associated with mortality. Methods We retrospectively describe a cohort of SOT recipients infected with SARS-CoV-2 at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between March 2020 and December 2022. Specific information regarding clinical presentation, course, management, and outcome were obtained from the electronic records. Results Eighty-one SOT recipients enrolled in the study, 65 (80%) kidney, 12 (15%) heart, and 4 (5%) liver transplants. The majority of SOT patients infected with COVID-19 were male (66.7%), had hypertension (67.9%), and take prednisone (97.5%), tacrolimus (92.6%), and antimetabolite (95%) at the time of diagnosis. Radiologically only 17 (34%) patients had images consistent with the diagnosis of COVID-19 pneumonia (50% liver, 35% kidney, and 22% heart). Thirty-three (40.7%) SOT patients were provided antivirals, steroids, convalescent plasma, IL-6 inhibitors, anticoagulation, and antibiotics. The survival rate was 97.5%, with only 2 deaths attributable to COVID-19 pneumonia, none had graft loss, 9 (22%) patients required admission to intensive care unit, 5 (12.2%) requiring mechanical ventilation, and 7 (17.1%) patients required a high-flow nasal cannula. Only bacterial coinfection was recognizable in 2 patients who also passed away; neither CMV nor fungal coinfections were evident. Conclusions There is no specific symptom for COVID-19 among SOT patients. Furthermore, severe complications and mortality rate are low among SOT patients infected with SARS-CoV-2. This may be related to close monitoring, early intervention, and vaccination used with SOT patients that may have a protective effect against detrimental COVID-19 outcomes.