COVID-19"s Initial Effect on the Solid Organ Transplant Population: Lessons Learned from the First Wave
Constantine M. Poulos2, Heather Kutzler1, Faiqa Cheema1, David O"Sullivan1, Glyn Morgan1, Caroline Rochon1, Patricia Sheiner1, Oscar Serrano1
1Surgery, Hartford Hospital, Hartford, Connecticut, United States, 2Surgery, University of Connecticut, Farmington, Connecticut, United States
OBJECTIVE: To compare solid organ transplant (SOT) recipients who presented as persons-under-investigation (PUIs) with COVID19 infection to those presenting with symptoms suggestive of infection during the initial phase of the COVID19 pandemic.
DESIGN: Retrospective cohort design.
SETTING: 7-hospital healthcare system from March 30th to 2020 to May 7th 2020.
PATIENTS: 69 SOT recipients presenting with concern for COVID19 infection.
MAIN OUTCOME MEASURE: 30-day mortality.
RESULTS: During the study time period, 69 SOT PUI patients were included in the analysis; 53 COVID19-, 16 COVID19+. The overall cohort included 43 kidney, 10 liver, 13 heart, and 3 combined transplants. COVID19+ patients did not differ from COVID19- patients in baseline demographic characteristics including age, gender, race, body mass index, or incidence of preexisting comorbidities. Symptomatically, both COVID- and COVID+ patients had similar initial presentations. Lab values on initial presentation was also similar between COVID- and COVID+ SOT patients. Compared to the COVID- cohort, COVID+ SOT recipients had a significantly higher overall thirty day mortality (31.3% versus 5.7%, p<0.05). In the COVID19- cohort, respiratory infections (22.6%) were the most common cause of presentation while non-COVD19 related sepsis was the most common cause of death (100%).
CONCLUSION: During the early phases of the COVID19 pandemic, COVID19+ SOT recipients had a significantly higher rate of 30-day mortality compared to similar PUIs who were ultimately COVID19 negative despite having similar demographic and clinical characteristics.
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