Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

doi:10.1111/ajt.16840

Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

Surgery

Producción científica: Article › revisión exhaustiva

72 Citas (Scopus)

Resumen

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.).

Idioma original	English
Páginas (desde-hasta)	279-288
Número de páginas	10
Publicación	American Journal of Transplantation
Volumen	22
N.º	1
DOI	https://doi.org/10.1111/ajt.16840
Estado	Published - ene 2022

Nota bibliográfica

Publisher Copyright:
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.

Financiación

This work was supported by the National Institute of Allergy and Infectious Diseases (T32AI118690 to M.R.H. and O.S.K.) and the National Heart, Lung, and Blood Institute (HL143050 to C.E.F.) at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The following are the members of the UW COVID-19 SOT Study Team, without whom this work would not have been possible: Behdad D. Besharatian MD, Maria Crespo MD, Rade Tomic MD, Sameep Sehgal MD, Dana Weisshaar MD, Reda Girgis MD, Cameron Lawrence BS, Joanna Nelson MD, William Bennett MD, Jennifer Leandro, Afrah Sait MD, Amy Rumore PharmD, Patricia West PhD, Amy Jeng MD, Valida Bajrovic MD, Erin P. Bilgili BS, Tracy Anderson-Haag PharmD, BCPS, Abigail Nastase, Abbas Badami MD, Jesus Alvarez-Garcia MD, Lyndsey Bowman-Anger PharmD, Lovelyn Julien MPH, Carlos Ortiz-Bautista MD, Rachel Friedman-Morocco MD, Kiran Gajurel MD, Lizbeth Cahuayme-Zuniga MD, Mark Wakefield MD, Monica Fung MD, Nicole Theodoropoulos MD, MS, Sally T. Chuang MD, Srividya Bhandaram MD, Massimiliano Veroux MD, PhD, Bhavna Chopra MD, Diana Florescu MD, Danielle Witteck, Daniela Diaz, Kathryn Ripley, NP-C, Kapil Saharia MD, MPH, Sanjeev Akkina MD, Todd P. McCarty MD, Ally Webb PharmD, Akanksha Arya MD, Giridhar Vedula MD, Jose-Marie El-Amm MD, M. Katherine Dokus, Arun Narayanan MD, Priscila Cilene Leon Bueno de Camargo MD, Rosemary Ouseph MD, Andrew Breuckner PharmD, Alfred Luk MD, Avinash Aujayeb MBBS, MRCP, Daniel Ganger MD, Douglas S. Keith MD, Federica Meloni MD, Ghady Haidar MD, Lori Zapernick, Megan Moraels MD, Nitender Goyal MD, Tanvi Sharma MD, MPH, Uma Malhotra MD, Alexander Kuo MD, Ana P. Rossi MD, MPH, Angelina Edwards MD, Brian Keller MD, PhD, Christy Beneri DO, Darby Derringer PharmD, Edward Dominguez MD, Elise Carlson PharmD, Faris Hashim MD, Haris Murad MD, Heinrike Wilkens MD, Henry Neumann MD, Imran Gani MD, Joseph Kahwaji MD, Joyce Popoola FRCP, Marian Michaels MD, MPH, Niyati Jakharia MD, Oveimar De la Cruz MD, Alfredo Puing MD, Reza Motallebzadeh, Ravi Velagapudi MD, Rajan Kapoor MD, Sridhar Allam MD, Fernanda Silveira MD, Surabhi Vora MD, MPH, Ursala M. Kelly MD, Uttam Reddy MD, Vikas Dharnidharka MD, MPH, Hani Wadei MD, and Lominadze Zurabi MD. This work was supported by the National Institute of Allergy and Infectious Diseases (T32AI118690 to M.R.H. and O.S.K.) and the National Heart, Lung, and Blood Institute (HL143050 to C.E.F.) at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Financiadores	Número del financiador
Faris Hashim MD
Kapil Saharia MD MPH
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)	HL143050
National Institute of Allergy and Infectious F32-AI286447 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R01AI168214 Jason W. Rosch Diseases National Institute of Allergy and Infectious P30 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R00-AI166116 Christopher D. Radka Diseases National Institute of Allergy and Infectious T32-AI106700 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R01AI192221 Jason W. Rosch Diseases National Inst...	T32AI118690
National Center for Advancing Translational Sciences (NCATS)	UL1TR001863

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

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@article{b89c80fedc6049acbf82e8c13d437408,

title = "Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic",

abstract = "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.).",

author = "Heldman, \{Madeleine R.\} and Kates, \{Olivia S.\} and Kassem Safa and Kotton, \{Camille N.\} and Georgia, \{Sarah J.\} and Steinbrink, \{Julie M.\} and Alexander, \{Barbara D.\} and Marion Hemmersbach-Miller and Blumberg, \{Emily A.\} and Ashrit Multani and Brandy Haydel and \{La Hoz\}, \{Ricardo M.\} and Lisset Moni and Yesabeli Condor and Sandra Flores and Munoz, \{Carlos G.\} and Juan Guitierrez and Diaz, \{Esther I.\} and Daniela Diaz and Rodrigo Vianna and Giselle Guerra and Matthias Loebe and Rakita, \{Robert M.\} and Maricar Malinis and Azar, \{Marwan M.\} and Vagish Hemmige and McCort, \{Margaret E.\} and Chaudhry, \{Zohra S.\} and Singh, \{Pooja P.\} and \{Hughes Kramer\}, Kailey and Arzu Velioglu and Yabu, \{Julie M.\} and Morillis, \{Jose A.\} and Mehta, \{Sapna A.\} and Tanna, \{Sajal D.\} and Michael G Ison and Derenge, \{Ariella C.\} and \{van Duin\}, David and Adrienne Maximin and Carlene Gilbert and Goldman, \{Jason D.\} and Lease, \{Erika D.\} and Fisher, \{Cynthia E.\} and Limaye, \{Ajit P.\} and \{De la Cruz\}, Oveimar and Besharatian, \{Behdad D.\} and Maria Crespo and Rade Tomic and Sameep Sehgal and Dana Weisshaar",

note = "Publisher Copyright: {\textcopyright} 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.",

year = "2022",

month = jan,

doi = "10.1111/ajt.16840",

language = "English",

volume = "22",

pages = "279--288",

number = "1",

}

TY - JOUR

T1 - Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

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

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.).

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JO - American Journal of Transplantation

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Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

Resumen

Nota bibliográfica

Financiación

ASJC Scopus subject areas

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