Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States

Am J Transplant. 2020 Nov;20(11):3061-3071. doi: 10.1111/ajt.16280. Epub 2020 Sep 15.


National data on patient characteristics, treatment, and outcomes of critically ill coronavirus disease 2019 (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 to May 8, 2020. From 4153 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.

Keywords: clinical research/practice; complication: infectious; infection and infectious agents - viral; infectious disease; kidney transplantation/nephrology; organ transplantation in general; patient survival.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • COVID-19 / epidemiology*
  • Comorbidity
  • Critical Illness / epidemiology
  • Critical Illness / therapy*
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Hospitalization / trends*
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Organ Transplantation*
  • Pandemics*
  • Risk Factors
  • SARS-CoV-2*
  • Survival Rate / trends
  • United States / epidemiology