Outcomes of Critically Ill Solid Organ Transplant Patients with COVID‐19 in the United States

Molnar, Miklos Z.; Bhalla, Anshul; Azhar, Ambreen; Tsujita, Makoto; Talwar, Manish; Balaraman, Vasanthi; Sodhi, Amik; Kadaria, Dipen; Eason, James D.; Hayek, Salim S.; Coca, Steven G.; Shaefi, Shahzad; Neyra, Javier A.; Gupta, Shruti; Leaf, David E.; Kovesdy, Csaba P.

National data on patient characteristics, treatment, and outcomes of critically ill COVID‐19 solid organ transplant(SOT) patients are limited. We analyzed data from a multicenter cohort study of adults with laboratory‐confirmed COVID‐19 admitted to intensive care units(ICUs) at 68 hospitals across the United States from March 4(th) to May 8(th), 2020. From 4,153 patients, we created a propensity score matched cohort of 386 patients, including 98 SOT patients and 288 non‐SOT patients. We used a binomial generalized linear model(log‐binomial model) to examine the association of SOT status with death and other clinical outcomes. Among the 386 patients, the median age was 60 years, 72% were male, and 41% were black. Death within 28 days of ICU admission was similar in SOT and non‐SOT patients(40% and 43%, respectively; relative risk[RR] 0.92 [95% Confidence Interval(CI):0.70‐1.22]). Other outcomes and requirement for organ support including receipt of mechanical ventilation, development of acute respiratory distress syndrome, and receipt of vasopressors were also similar between groups. There was a trend toward higher risk of acute kidney injury requiring renal replacement therapy in SOT vs. non‐SOT patients (37% vs. 27%; RR[95%CI]:1.34 [0.97‐1.85]). Death and organ support requirement were similar between SOT and non‐SOT critically ill patients with COVID‐19.