SARS-CoV-2 infection and early mortality of waitlisted and solid organ transplant recipients in England: A national cohort study.
Rommel RavananChris J CallaghanLisa MumfordInes Ushiro-LumbDouglas ThorburnJohn CaseyPeter FriendJayan ParameshwarIan CurrieLisa BurnappRichard BakerJan DudleyGabriel C OniscuMarius BermanJohn AsherDan HarveyAlex R ManaraDerek ManasDale GardinerJohn L R ForsythePublished in: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2020)
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.
Keyphrases
- sars cov
- respiratory syndrome coronavirus
- end stage renal disease
- coronavirus disease
- public health
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- physical activity
- healthcare
- machine learning
- squamous cell carcinoma
- mental health
- social support
- artificial intelligence
- genome wide
- radiation therapy
- big data
- gene expression
- quality improvement
- health insurance
- risk assessment
- deep learning
- hiv infected
- men who have sex with men