COVID-19 Severity and Mortality in Solid Organ Transplantation: Differences between Liver, Heart, and Kidney Recipients

Abstract

The infection by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can generate a wide spectrum of clinical manifestations ranging from asymptomatic to severe respiratory and systemic disease with coagulation disorder named coronavirus disease 2019 (COVID-19). Patients with comorbidities have been identified as risk groups for severe COVID-19, also having a higher death risk. Previous reports have conflicting results regarding if solid organ transplant recipients present an increased risk for COVID-19. Nevertheless, previous investigations failed to distinguish between different organs received or made a longitudinal investigation on those patients. We recruited 39 solid organ transplant recipients: 25 kidney transplant recipients, 7 heart transplant recipients, and 7 liver transplant recipients and 25 age-matched non-transplant COVID-19 patients without comorbidities (control group) and compared daily laboratory data in addition to performing survival analysis. Heart and kidney transplant recipients presented an increase in several COVID-19 severity-associated biomarkers, such as neutrophil-to-lymphocyte ratio and thrombocytopenia, in comparison to the control group and liver transplant recipients. Heart and kidney transplant recipients also presented an increase in the need for intensive care and invasive mechanical ventilation during the disease’s course. Importantly, heart and kidney transplant recipients presented a higher mortality rate in comparison to liver transplant recipients and non-transplant recipients. In our cohort, heart and kidney transplant recipients presented a difference in clinical characteristics and survival rate in comparison to liver transplant recipients. Further investigation involving immune response to SARS-CoV-2 in solid organ recipients should consider and separate patients according to the organ grafted.

Determinants of death in critically ill COVID-19 patients during the first wave of COVID-19: a multicenter study in Brazil

“…175 (65,1) Disfunção de múltiplos órgãos 37 (13,8) Hipoxemia 16 (5,9) Falência do sistema nervoso central 9 (3,3) Infarto agudo do miocárdio (23) analisaram a mortalidade em pacientes transplantados de órgãos sólidos e constataram que os transplantados renais e cardíacos apresentaram maior risco de óbito em comparação com os transplantados hepáticos. Quase 35% dos pacientes de nossa coorte necessitaram de TRS, o que é muito superior ao relatado em um estudo anterior.…”

Long-term effects of COVID-19 in diabetic and non-diabetic patients

“…The severe respiratory coronavirus-2 (SARS-CoV-2) infection can lead to a potentially deadly disease named coronavirus disease 2019 (COVID-19). COVID-19 death rate is higher in elderlies ( 1 ) and individuals with comorbidities ( 2 , 3 ).…”

Platelet-Based Biomarkers for Diagnosis and Prognosis in COVID-19 Patients

“…COVID-19 severity degree ranges from asymptomatic to a severe systemic disease with respiratory and/or multiorgan damage, and a clinical course that can rapidly progress to deadly complications [1]. Comorbidities such as respiratory disorders [2], organ transplant recip-Life 2021, 11, 1005. https://doi.org/10.3390/life11101005 https://www.mdpi.com/journal/life ients [3], metabolic disorders [4], and old age [5] are frequently associated with a worse clinical outcome in SARS-CoV-2-infected patients.…”