SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study
Abstract
Patients waitlisted for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by linkage of the UK transplant registry and Public Health England and NHS Digital Tracing services, we examined the incidence of laboratory-confirmed SARS-CoV-2 infection and subsequent mortality in patients on the active waiting list for a deceased donor SOT and recipients with a functioning SOT as of February 1, 2020 with follow-up to May 20, 2020. Univariate and multivariable techniques were used to compare differences between groups and to control for case-mix. One hundred ninety-seven (3.8%) of the 5184 waitlisted patients and 597 (1.3%) of the 46 789 SOT recipients tested positive for SARS-CoV-2. Mortality after testing positive for SARS-CoV-2 was 10.2% (20/197) for waitlisted patients and 25.8% (154/597) for SOT recipients. Increasing recipient age was the only variable independently associated with death after positive SARS-CoV-2 test. Of the 1004 transplants performed in 2020, 41 (4.1%) recipients have tested positive for SARS-CoV-2 with 8 (0.8%) deaths reported by May 20. These data provide evidence to support decisions on the risks and benefits of SOT during the coronavirus disease 2019 pandemic. Copyright © 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
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Date
2020
Type
Article
Subject
COVID-19 pandemic, Death, Organ transplantation, SARS-CoV-2, COVID-19
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Ravanan, R., Callaghan, C.J., Mumford, L., Ushiro-Lumb, I., Thorburn, D., Casey, J., Friend, P., Parameshwar, J., Currie, I., Burnapp, L., Baker, R., Dudley, J., Oniscu, G.C., Berman, M., Asher, J., Harvey, D.J., Manara, A., Manas, D., Gardiner, D. C. and Forsythe, J.L.R. (2020) 'SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study', American Journal of Transplantation, 20(11), pp. 3008-3018. doi: 10.1111/ajt.16247.
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Article is free to view here: https://doi.org/10.1111/ajt.16247