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COVID-19 in transplant recipients: The Spanish experience

Elisabeth Coll1, Mario Fernández-Ruiz2,3, J Emilio Sánchez-Álvarez4,5

  • 1Organización Nacional de Trasplantes (Spanish National Transplant Organization), Madrid, Spain.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|October 24, 2020
PubMed

Insights

Solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients in Spain had a higher incidence of coronavirus disease 2019 (COVID-19). Lung transplant recipients, older age, and hospital-acquired COVID-19 were risk factors for mortality in these vulnerable patients.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Transplantation Medicine

Background:

  • Solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients are considered a vulnerable population for infectious diseases.
  • The impact of coronavirus disease 2019 (COVID-19) on SOT and HSCT recipients in Spain was not well-documented.

Purpose of the Study:

  • To describe the nationwide experience of COVID-19 in SOT and HSCT recipients in Spain.
  • To identify risk factors associated with mortality in this patient cohort.

Main Methods:

  • A nationwide retrospective study was conducted, compiling data on SOT and HSCT recipients diagnosed with COVID-19 in Spain until July 13, 2020.
  • Data collected included patient demographics, transplant type, interval from transplantation, infection source, therapies received, and clinical outcomes.
  • Univariate analysis was performed to identify risk factors for death.

Main Results:

  • A total of 778 recipients (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung) were included. The incidence of COVID-19 was double that of the general Spanish population.
  • Most patients (89%) were hospitalized, and 27% (174 patients) died. Acute respiratory distress syndrome occurred in 35% of patients.
  • Risk factors for death included lung transplantation (OR: 2.5), age over 60 years (OR: 3.7), and hospital-acquired COVID-19 (OR: 3.0).

Conclusions:

  • SOT and HSCT recipients in Spain experienced a significant burden of COVID-19 with a high mortality rate.
  • Lung transplantation, older age, and hospital-acquired infections are critical risk factors for mortality in this immunocompromised group.
  • These findings highlight the need for stringent preventive measures and tailored management strategies for COVID-19 in transplant recipients.

Keywords:
antibiotic: antiviralclinical decision-makingclinical research/practicecomplication: infectiousinfection and infectious agents - viralinfectious disease

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