Delayed Mortality Among Solid Organ Transplant Recipients Hospitalized for COVID-19

INTRODUCTION: Most studies of solid organ transplant (SOT) recipients with COVID-19 focus on outcomes within one month of illness onset. Delayed mortality in SOT recipients hospitalized for COVID-19 has not been fully examined. METHODS: We used data from a multicenter registry to calculate mortality by 90 days following initial SARS-CoV-2 detection in SOT recipients hospitalized for COVID-19 and developed multivariable Cox proportional-hazards models to compare risk factors for death by days 28 and 90. RESULTS: Vital status at day 90 was available for 936 of 1117 (84%) SOT recipients hospitalized for COVID-19: 190 of 936 (20%) died by 28 days and an additional 56 of 246 deaths (23%) occurred between days 29 and 90. Factors associated with mortality by day 90 included: age > 65 years [aHR 1.8 (1.3-2.4), p =<0.001], lung transplant (vs. non-lung transplant) [aHR 1.5 (1.0-2.3), p=0.05], heart failure [aHR 1.9 (1.2-2.9), p=0.006], chronic lung disease [aHR 2.3 (1.5-3.6), p<0.001] and body mass index ≥ 30 kg/m 2 [aHR 1.5 (1.1-2.0), p=0.02]. These associations were similar for mortality by day 28. Compared to diagnosis during early 2020 (March 1-June 19, 2020), diagnosis during late 2020 (June 20-December 31, 2020) was associated with lower mortality by day 28 [aHR 0.7 (0.5-1.0, p=0.04] but not by day 90 [aHR 0.9 (0.7-1.3), p=0.61]. CONCLUSIONS: In SOT recipients hospitalized for COVID-19, >20% of deaths occurred between 28 and 90 days following SARS-CoV-2 diagnosis. Future investigations should consider extending follow-up duration to 90 days for more complete mortality assessment.

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UNC Libraries
Published
2025-04-18
DOI
https://doi.org/10.17615/9pfm-f251
Primary Topic
Renal Transplantation Outcomes and Treatments
Type
article
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article

Delayed Mortality Among Solid Organ Transplant Recipients Hospitalized for COVID-19

Ricardo M. La Hoz, Barbara D. Alexander, Camille N. Kotton, Julie M. Yabu et al.
UNC Libraries
Renal Transplantation Outcomes and Treatments
article

Delayed Mortality Among Solid Organ Transplant Recipients Hospitalized for COVID-19

Ricardo M. La Hoz, Barbara D. Alexander, Camille N. Kotton, Julie M. Yabu, Sajal D. Tanna, Esther I. Diaz, Olivia S. Kates, Daniela Diaz, Juan Guitierrez, Vagish Hemmige, Brandy Haydel, Jason D. Goldman, Sameer Mehta, Emily A. Blumberg, Robert M. Rakita, Julie M. Steinbrink, Margaret McCort, Marwan M. Azar, Rodrigo Vianna, Kassem Safa, Anna Wald, Marion Hemmersbach‐Miller, Erika D. Lease, Yesabeli Condor, David van Duin, Michael G. Ison, Matthias Loebe, Ashrit Multani, Madeleine R. Heldman, Giselle Guerra, Maricar Malinis, Arzu Velioğlu, Lisset Moni, Pooja Singh, Sarah J. Georgia, Kailey Hughes Kramer, Cynthia E. Fisher, C. Muñoz, Ajit P. Limaye, Sandra Flores, UW Covid- SOT Study Team
article en

Abstract

INTRODUCTION: Most studies of solid organ transplant (SOT) recipients with COVID-19 focus on outcomes within one month of illness onset. Delayed mortality in SOT recipients hospitalized for COVID-19 has not been fully examined. METHODS: We used data from a multicenter registry to calculate mortality by 90 days following initial SARS-CoV-2 detection in SOT recipients hospitalized for COVID-19 and developed multivariable Cox proportional-hazards models to compare risk factors for death by days 28 and 90. RESULTS: Vital status at day 90 was available for 936 of 1117 (84%) SOT recipients hospitalized for COVID-19: 190 of 936 (20%) died by 28 days and an additional 56 of 246 deaths (23%) occurred between days 29 and 90. Factors associated with mortality by day 90 included: age > 65 years [aHR 1.8 (1.3-2.4), p =<0.001], lung transplant (vs. non-lung transplant) [aHR 1.5 (1.0-2.3), p=0.05], heart failure [aHR 1.9 (1.2-2.9), p=0.006], chronic lung disease [aHR 2.3 (1.5-3.6), p<0.001] and body mass index ≥ 30 kg/m 2 [aHR 1.5 (1.1-2.0), p=0.02]. These associations were similar for mortality by day 28. Compared to diagnosis during early 2020 (March 1-June 19, 2020), diagnosis during late 2020 (June 20-December 31, 2020) was associated with lower mortality by day 28 [aHR 0.7 (0.5-1.0, p=0.04] but not by day 90 [aHR 0.9 (0.7-1.3), p=0.61]. CONCLUSIONS: In SOT recipients hospitalized for COVID-19, >20% of deaths occurred between 28 and 90 days following SARS-CoV-2 diagnosis. Future investigations should consider extending follow-up duration to 90 days for more complete mortality assessment.

UNC Libraries
University of North Carolina at Chapel Hill (US)
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Renal Transplantation Outcomes and Treatments
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