Characteristics and outcomes of solid organ transplant patients with COVID-19 at a north texas community based transplant center

Background: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become a public health emergency and pandemic of international concern Transplant recipients may be at increased risk of infection and worse clinical outcomes due to immunosuppression as well frequent contact with the health care system However, there is limited data regarding susceptibility, clinical outcomes, and ideal management of organ transplant recipients who develop COVID-19 Methods: This is a single center, retrospective study describing 9 SOT recipients diagnosed with COVID-19 between April 1, 2020 and June 30, 2020 at a North Texas community-based transplant center At our multidisciplinary transplant institute, we instituted a rigorous protocol to educate our SOT recipients and minimize their exposure to COVID-19 Baseline demographic characteristics, clinical course, treatment modalities, and patient outcomes were compared between transplant and non-transplant patients using Fisher's Exact test and Mann-Whitney test Results: Our data includes 402 non-transplant patients and 9 SOT recipients diagnosed with COVID-19 by PCR during a 12 week period Among the transplant cohort, there were 4 liver transplants, 4 kidney transplants, and 1 kidney-pancreas transplant Average time from transplant was 9 8 ± 9 1 years Mean age of transplant patients was 57 7 ± 9 3 years When compared to non-transplant patients, SOT recipients had similar age, BMI, and co-morbidities, including diabetes, HTN, CAD, and chronic lung disease Transplant patients had higher rates of CKD than non-transplant patients (66% vs 13 9%) There was no difference in the average length of stay (LOS) (12 9 ± 12 7 vs 13 4 ± 12 0 days), days in ICU (6 0 ± 13 0 vs 5 7 ±10 8 days) or days requiring mechanical ventilation (4 4 ± 13 vs 4 4 ± 10 0 days) for transplant vs non-transplant patients There was no difference in treatment modalities used (Hydroxychloroquine, Azithromycin, Remdesivir, Tocilizumab and convalescent plasma) between the two groups, aside from plasma, which was used at a higher rate in the nontransplant group (45 4% vs 11 1%) There were two deaths in the transplant cohort There was no statistically significant difference in mortality between transplant vs non-transplant patients (22 2% vs 14 5%, p = 0 63) Conclusion: There was no statistically significant difference between transplant and non-transplant patients in regards to demographics, overall co-morbidities, LOS, days in ICU, need for mechanical ventilation, or inpatient mortality Given the small sample size of transplant patients, this data is not conclusive;however, it is encouraging given that this is a population considered at high risk for poor outcomes Multi-center, longitudinal studies with a larger sample size are needed for further research