A Multicenter Prospective Registry Study of Lung Transplant Recipients Hospitalized with COVID-19
Heldman MR, Kates OS, Multani A, Steinbrink JM, Lewis AV, Alexander BD, Beaird OE, Sehgal S, Mishkin AD, La Hoz RM, Blumberg EA, Nelson J, Safa K, Kotton CN, Hemmersbach-Miller M, Chaudhry ZS, Saharia K, Morillas JA, Rakita RM, Sait AS, Meloni F, Wilkens H, Camargo P, Tanna SD, Tomic R, Ison MG, Lease ED, Fisher CE, and Limaye AP. A Multicenter Prospective Registry Study of Lung Transplant Recipients Hospitalized with COVID-19. J Heart Lung Transplant 2021; 40(4):S141.
The Journal of heart and lung transplantation
Purpose: Outcomes of lung transplant recipients (LTR) hospitalized for COVID-19 and comparisons to non-lung solid organ transplant recipients (SOTR) are incompletely described.
Methods: Using a multicenter prospective registry of SOTR, we examined 28-day outcomes (mortality [primary outcome], intensive care unit (ICU) admission, mechanical ventilation, and bacterial pneumonia) among both LTR and non-lung SOTR hospitalized with laboratory-confirmed COVID-19 diagnosed between March 1, 2020 and September 21, 2020. Data were analyzed using Stata (StataCorp, College Station, TX); chi-square tests were used to compare categorical variables and multivariable logistic regression was used to assess risk factors for mortality.
Results: The cohort included 72 LTR and 392 non-lung SOTR (Table 1). Overall, 28-day mortality trended higher in LTR vs. non-lung SOTR (27.8% vs. 19.9%, P=0.136). Other 28-day outcomes were similar between LTR and non-lung SOTR: ICU admission (45.8% vs. 39.1%, P=0.28), mechanical ventilation (32.9% vs. 31.1%, P=0.78), and bacterial pneumonia (15.3% vs. 8.2%, P=0.063). Congestive heart failure, diabetes, age >65 years, and obesity (BMI >= 30) were independently associated with mortality in non-lung SOTR, but not in LTR (Table 2).
Conclusion: In this large prospective cohort comparing lung and non-lung SOTR hospitalized for COVID-19, there were high but not significantly different rates of short-term morbidity and mortality. Baseline comorbidities appeared to drive mortality in non-lung SOTR but not LTR. Further studies are needed to identify risk factors for mortality among LTR.