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Risk factors for SARS-CoV-2 infection and severe COVID-19 in unvaccinated solid organ transplant recipients
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Risk factors for SARS-CoV-2 infection and severe COVID-19 in unvaccinated solid organ transplant recipients
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Risk factors for SARS-CoV-2 infection and severe COVID-19 in unvaccinated solid organ transplant recipients
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Journal Article
Risk factors for SARS-CoV-2 infection and severe COVID-19 in unvaccinated solid organ transplant recipients
2024
Overview
The role of immunosuppressive therapy on SARS-CoV-2 infection risk and COVID-19 severity remains unclear in unvaccinated solid organ transplant recipients. We included 1957 organ transplant recipients between July 2020 and April 2021 to analyze whether baseline immunosuppressive therapy and other risk factors are associated with SARS-CoV-2 infection and severe COVID-19. In total, 247 (12.6%) had SARS-CoV-2 (defined as positive nasopharyngeal swab and/or positive antibody titer). Of these, 57 (23.1%) had severe COVID-19, defined as oxygen supplementation, intensive care unit admission or death. Multivariable analysis identified diabetes (hazard ratio (HR) 1.39 (95% confidence interval (CI) 1.05–1.83)), chronic lung disease (HR 1.71 (95% CI 1.13–2.60)) and contact with a COVID-19 positive individual (HR 3.61 (95% CI 2.61–4.99) as independent risk factors for SARS-CoV-2 infection. There was no association between immunosuppressive therapy and infection risk. Severe COVID-19 was multivariably associated with hypertension (OR 5.45 (95% CI 1.66–17.84)), chronic kidney disease (OR 3.55 (95% CI 1.75–7.19)), corticosteroid use (OR 2.93 (95% CI 1.03–2.55)) and having a COVID-19 positive housemate (OR 6.77 (95% CI 2.65–17.28)). In conclusion, baseline corticosteroid use, but no other immunosuppressive agent, is independently associated with severe COVID-19 in unvaccinated SOT recipients after correction for hypertension, chronic kidney disease, housemates affected by COVID-19 and transplant type.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 692/499
/ Adult
/ Aged
/ COVID-19
/ Female
/ Humanities and Social Sciences
/ Humans
/ Immunosuppressive Agents - adverse effects
/ Immunosuppressive Agents - therapeutic use
/ Kidneys
/ Male
/ Organ Transplantation - adverse effects
/ SARS-CoV-2 - isolation & purification
/ Science
/ Severe acute respiratory syndrome coronavirus 2
/ Steroids
