Clinical Outcomes of Solid Organ Transplant Recipients Hospitalized with COVID-19: A Propensity Score-Matched Cohort Study
- Author:
Jeong-Hoon LIM
1
;
Eunkyung NAM
;
Yu Jin SEO
;
Hee-Yeon JUNG
;
Ji-Young CHOI
;
Jang-Hee CHO
;
Sun-Hee PARK
;
Chan-Duck KIM
;
Yong-Lim KIM
;
Sohyun BAE
;
Soyoon HWANG
;
Yoonjung KIM
;
Hyun-Ha CHANG
;
Shin-Woo KIM
;
Juhwan JUNG
;
Ki Tae KWON
Author Information
- Publication Type:Original Article
- From:Infection and Chemotherapy 2024;56(3):329-338
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Solid-organ transplant recipients (SOTRs) receiving immunosuppressive therapy are expected to have worse clinical outcomes from coronavirus disease 2019 (COVID-19). However, published studies have shown mixed results, depending on adjustment for important confounders such as age, variants, and vaccination status.
Materials and Methods:We retrospectively collected the data on 7,327 patients hospitalized with COVID-19 from two tertiary hospitals with government-designated COVID-19 regional centers. We compared clinical outcomes between SOTRs and non-SOTRs by a propensity score-matched analysis (1:2) based on age, gender, and the date of COVID-19 diagnosis. We also performed a multivariate logistic regression analysis to adjust other important confounders such as vaccination status and the Charlson comorbidity index.
Results:After matching, SOTRs (n=83) had a significantly higher risk of high-flow nasal cannula use, mechanical ventilation, acute kidney injury, and a composite of COVID-19 severity outcomes than non-SOTRs (n=160) (all P <0.05). The National Early Warning Score was significantly higher in SOTRs than in non-SOTRs from day 1 to 7 of hospitalization ( P for interaction=0.008 by generalized estimating equation). In multivariate logistic regression analysis, SOTRs (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.12–4.11) and male gender (OR, 2.62; 95% CI, 1.26– 5.45) were associated with worse outcomes, and receiving two to three doses of COVID-19 vaccine (OR, 0.43; 95% CI, 0.24–0.79) was associated with better outcomes.
Conclusion:Hospitalized SOTRs with COVID-19 had a worse prognosis than non-SOTRs. COVID-19 vaccination should be implemented appropriately to prevent severe COVID-19 progression in this population.
