COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Amanda J. Vinson; Gaurav Agarwal; Ran Dai; Alfred J. Anzalone; Stephen B. Lee; Evan French; Amy Olex; Vithal Madhira; Roslyn B. Mannon

doi:10.1097/TXD.0000000000001234

COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Amanda J. Vinson, Gaurav Agarwal, Ran Dai, Alfred J. Anzalone, Stephen B. Lee, Evan French, Amy Olex, Vithal Madhira, Roslyn B. Mannon

Medicine

Research output: Contribution to journal › Article › peer-review

46 Citations (Scopus)

Abstract

Background. Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States. Methods. In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored. Results. Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss. Conclusions. In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.

Original language	English
Article number	e775
Journal	Transplantation Direct
Volume	7
Issue number	11
DOIs	https://doi.org/10.1097/TXD.0000000000001234
Publication status	Published - Oct 6 2021

Bibliographical note

Funding Information:
A.O. and E.F. were supported by CTSA award no. UL1TR002649 from the National Center for Advancing Translational Sciences (NCATS). The analyses described in this publication were conducted with data or tools accessed through the NCATS National COVID Cohort Collaborative (N3C) Data Enclave https://covid.cd2h.org and N3C Attribution and Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306 and by the National Institute of General Medical Sciences, U54 GM115458, which funds the Great Plains Institutional Development Award Network for Clinical and Translational Research. R.B.M. is supported by BMX003272 and U01DK115997.

Funding Information:
A.J.V. has done consultancy work and received funding for a fellowship project grant through Paladin Labs Inc. G.A. has received educational funds from Mallinckrodt Pharmaceuticals and has served as principal investigator for studies by Mallinckrodt Pharmaceuticals and CSL Behring. R.B.M. reports grants from Mallinckrodt, Care Dx, CSL Behring, Transplant Genomics, Astellas, and Quark Pharmaceuticals; personal fees from Vitaerris as member of the IMAGINE Trial Steering committee; personal fees from Novartis, Sanofi, and Hansa; and personal fees from American Journal of Transplantation as Deputy Editor of the journal, outside the submitted work. The other authors declare no conflicts of interest.

Publisher Copyright:
© 2021 Wolters Kluwer Health. All rights reserved.

ASJC Scopus Subject Areas

Transplantation

PubMed: MeSH publication types

Journal Article

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10.1097/TXD.0000000000001234

Cite this

@article{0ba659ecfcc3440783ac9b6892862a47,

title = "COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative",

abstract = "Background. Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States. Methods. In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored. Results. Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss. Conclusions. In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.",

author = "Vinson, {Amanda J.} and Gaurav Agarwal and Ran Dai and Anzalone, {Alfred J.} and Lee, {Stephen B.} and Evan French and Amy Olex and Vithal Madhira and Mannon, {Roslyn B.}",

note = "Funding Information: A.O. and E.F. were supported by CTSA award no. UL1TR002649 from the National Center for Advancing Translational Sciences (NCATS). The analyses described in this publication were conducted with data or tools accessed through the NCATS National COVID Cohort Collaborative (N3C) Data Enclave https://covid.cd2h.org and N3C Attribution and Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306 and by the National Institute of General Medical Sciences, U54 GM115458, which funds the Great Plains Institutional Development Award Network for Clinical and Translational Research. R.B.M. is supported by BMX003272 and U01DK115997. Funding Information: A.J.V. has done consultancy work and received funding for a fellowship project grant through Paladin Labs Inc. G.A. has received educational funds from Mallinckrodt Pharmaceuticals and has served as principal investigator for studies by Mallinckrodt Pharmaceuticals and CSL Behring. R.B.M. reports grants from Mallinckrodt, Care Dx, CSL Behring, Transplant Genomics, Astellas, and Quark Pharmaceuticals; personal fees from Vitaerris as member of the IMAGINE Trial Steering committee; personal fees from Novartis, Sanofi, and Hansa; and personal fees from American Journal of Transplantation as Deputy Editor of the journal, outside the submitted work. The other authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2021 Wolters Kluwer Health. All rights reserved.",

year = "2021",

month = oct,

day = "6",

doi = "10.1097/TXD.0000000000001234",

language = "English",

volume = "7",

journal = "Transplantation Direct",

issn = "2373-8731",

publisher = "Wolters Kluwer Health",

number = "11",

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TY - JOUR

T1 - COVID-19 in Solid Organ Transplantation

T2 - Results of the National COVID Cohort Collaborative

AU - Vinson, Amanda J.

AU - Agarwal, Gaurav

AU - Dai, Ran

AU - Anzalone, Alfred J.

AU - Lee, Stephen B.

AU - French, Evan

AU - Olex, Amy

AU - Madhira, Vithal

AU - Mannon, Roslyn B.

N1 - Funding Information: A.O. and E.F. were supported by CTSA award no. UL1TR002649 from the National Center for Advancing Translational Sciences (NCATS). The analyses described in this publication were conducted with data or tools accessed through the NCATS National COVID Cohort Collaborative (N3C) Data Enclave https://covid.cd2h.org and N3C Attribution and Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306 and by the National Institute of General Medical Sciences, U54 GM115458, which funds the Great Plains Institutional Development Award Network for Clinical and Translational Research. R.B.M. is supported by BMX003272 and U01DK115997. Funding Information: A.J.V. has done consultancy work and received funding for a fellowship project grant through Paladin Labs Inc. G.A. has received educational funds from Mallinckrodt Pharmaceuticals and has served as principal investigator for studies by Mallinckrodt Pharmaceuticals and CSL Behring. R.B.M. reports grants from Mallinckrodt, Care Dx, CSL Behring, Transplant Genomics, Astellas, and Quark Pharmaceuticals; personal fees from Vitaerris as member of the IMAGINE Trial Steering committee; personal fees from Novartis, Sanofi, and Hansa; and personal fees from American Journal of Transplantation as Deputy Editor of the journal, outside the submitted work. The other authors declare no conflicts of interest. Publisher Copyright: © 2021 Wolters Kluwer Health. All rights reserved.

PY - 2021/10/6

Y1 - 2021/10/6

N2 - Background. Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States. Methods. In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored. Results. Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss. Conclusions. In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.

AB - Background. Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States. Methods. In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored. Results. Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss. Conclusions. In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.

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JO - Transplantation Direct

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COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Abstract

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PubMed: MeSH publication types

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