Clinical transplantation · 2026
Comparing the Post-Omicron Impact of COVID-19 and Non-COVID-19 Respiratory Viral Infections in Solid Organ Transplant Recipients.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sim Beatrice Z, Steinbrink Julie M, Heldman Madeleine R, Baker Arthur W, Messina Julia A, Arif Sana, Ni Bin, Tam Patrick C K, Carugati Manuela, Mah Jordan, Goodwin Matthew, Schwartz Ilan S, Slavin Monica A, Yong Michelle K, Wolfe Cameron R
Аннотация
INTRODUCTION: Effective treatment and prevention for respiratory viral infections (RVI) in solid organ transplant recipients (SOTR) are lacking; clinical differences in COVID-19 and non-COVID-19 (ncRVI) post-omicron are unknown. We compared severity and outcomes across SOT groups.
METHODS: A single-center retrospective study of health system RVI in adult SOTR during 2022-2023 was conducted.
RESULTS: Overall, 520 RVI episodes in 504 patients were included: 488 had 1 episode and 16 had 2 episodes. Lung, kidney, and heart transplant recipients comprised of 40.9%, 34.3%, and 20.8% of the cohort. There were 352 episodes of COVID-19 RVI and 148 ncRVI. All-cause and RVI-related hospitalization were comparable between COVID-19 and ncRVI (47.7% vs. 43.9%, p = 0.50; 32.1% vs. 31.1%, p = 0.91 respectively). Oxygen supplementation occurred in 11.9% of COVID-19 RVI and 11.5% of ncRVI with a maximum requirement (median, IQR) of 4.0 (2.0-18.8) and 2.0 (2.0-3.0) liters respectively (p = 0.005). Intensive care unit (ICU) admission occurred in 7.1% and 6.1%; non-invasive ventilation (NIV) in 2.3% and 4.1%; mechanical ventilation (I&V) in 4.0% and 2.0%; and inotropic/vasopressor support in 1.7% and 1.4%, for COVID-19 versus nCRVI, respectively. Patients with COVID-19 had ongoing symptoms in 16.8%, 10.2%, and 2.6% at 30 days, 3 month, and 12 month follow up respectively, compared with 16.9%, 4.7%, and 2.0% in ncRVI. Twelve-month mortality, rejection and graft dysfunction were similar between groups.
CONCLUSIONS: COVID-19 and ncRVI pose significant and comparable risk to SOTR in this post-omicron era, in hospitalization, oxygen requirement, and persistent symptoms. Treatment and prevention should be prioritized in this population.
METHODS: A single-center retrospective study of health system RVI in adult SOTR during 2022-2023 was conducted.
RESULTS: Overall, 520 RVI episodes in 504 patients were included: 488 had 1 episode and 16 had 2 episodes. Lung, kidney, and heart transplant recipients comprised of 40.9%, 34.3%, and 20.8% of the cohort. There were 352 episodes of COVID-19 RVI and 148 ncRVI. All-cause and RVI-related hospitalization were comparable between COVID-19 and ncRVI (47.7% vs. 43.9%, p = 0.50; 32.1% vs. 31.1%, p = 0.91 respectively). Oxygen supplementation occurred in 11.9% of COVID-19 RVI and 11.5% of ncRVI with a maximum requirement (median, IQR) of 4.0 (2.0-18.8) and 2.0 (2.0-3.0) liters respectively (p = 0.005). Intensive care unit (ICU) admission occurred in 7.1% and 6.1%; non-invasive ventilation (NIV) in 2.3% and 4.1%; mechanical ventilation (I&V) in 4.0% and 2.0%; and inotropic/vasopressor support in 1.7% and 1.4%, for COVID-19 versus nCRVI, respectively. Patients with COVID-19 had ongoing symptoms in 16.8%, 10.2%, and 2.6% at 30 days, 3 month, and 12 month follow up respectively, compared with 16.9%, 4.7%, and 2.0% in ncRVI. Twelve-month mortality, rejection and graft dysfunction were similar between groups.
CONCLUSIONS: COVID-19 and ncRVI pose significant and comparable risk to SOTR in this post-omicron era, in hospitalization, oxygen requirement, and persistent symptoms. Treatment and prevention should be prioritized in this population.