COVID-19 Hospitalization Risk Among Solid Organ Transplant Recipients

Recipients of solid organ transplants are at increased risk of severe infection with SARS-CoV-2 compared with the general population. Epiphane Kolla, MD, MPH, and colleagues conducted a study to determine which health conditions and immunosuppressive drugs are associated with the risk of hospitalization related to COVID-19 in that patient population. 

The study included 60,456 participants. Median age was 59 years, 63.7% were male, 68.6% (n=41,463) had kidney transplant, 23.9% (n=14,464) had liver transplant, 8.8% (n=5327) had heart transplant, and 4.6% (n=2823) had lung transplant. COVID-19-related hospitalization occurred in 12.7% of the kidney transplant recipients, 6.4% of liver transplant recipients, 12.9% of heart transplant recipients, and 18.0% of lung transplant recipients. 

In kidney transplant recipients and liver transplant recipients, steroids and mycophenolic acid were associated with a high risk of hospitalization for COVID-19. In heart transplant recipients, steroids and mycophenolic acid, sirolimus, and everolimus were associated with an increased risk of hospitalization. In lung transplant recipients, only steroids were associated with a high risk of hospitalization. 

In liver transplant recipients, tacrolimus was associated with a decreased risk of hospitalization. In heart transplant recipients, cyclosporine was associated with decreased risk. 

“This study suggests that mycophenolic acid, sirolimus, and steroids are associated with an increased risk of COVID-19-related hospitalization in solid organ transplant recipients,” the authors said. “These results should be considered by clinicians treating transplant recipients and may help inform epidemic-related decisions for this population in the future.” 

Source: JAMA Network Open