Post-Acute Sequelae of SARS-CoV-2 Infection in Transplant Recipients

A group of researchers, including Leela Morená, MD, investigated the prevalence of post-acute sequelae of SARS-CoV-2 infection (PASC) in solid organ transplant recipients (SOTRs) infected during the Omicron phase and the associations between clinical characteristics and the development of PASC symptoms. They presented their findings at the American Transplant Congress 2024.

The cross-sectional study followed patients who had a COVID-19 infection during the Omicron period (December 28, 2021, to November 4, 2022) and surveyed them from September 29, 2023, to December 1, 2023. The survey used a PASC score that included 13 symptoms experienced for ≥30 days. Patients were categorized as having PASC if they scored ≥12.

Of 299 SOTRs invited to take the survey, 93 completed it. Their mean age was 58 years (±13) and 43% were female. The most common type of transplantation was kidney (44%), and median time since transplantation was 4.1 years (interquartile range, 2.1-7.7). There were 46 SOTRs (49%) who reported having ≥1 PASC symptom for ≥30 days. Those who experienced symptoms had an average of 3 symptoms at 2 months postinfection. This number decreased to 1.6 symptoms at 12 months postinfection.

According to the scoring method used, 13 (14%) SOTRs met the definition of PASC. Multivariable analysis found that female sex (adjusted odds ratio [aOR], 0.32; 95% CI, 0.12-0.83), years since transplantation (aOR, 0.90 per additional year; 95% CI, 0.81-0.99), and tixagevimab-cilgavimab pre-exposure prophylaxis (aOR, 0.33; 95% CI, 0.12-0.84) were associated with significantly lower odds for developing ≥1 PASC symptom.

The authors concluded that PASC symptoms were common in SOTRs during the Omicron period, but patients with female sex, longer time since transplantation, and use of tixagevimab-cilgavimab had lower chances of developing PASC symptoms. “New prevention and treatment strategies for SARS-CoV-2 infection should also evaluate PASC symptoms as outcomes,” they wrote.

Source: Morená L, Al Jurdi A, El Mouhayyar C, et al. Post-COVID sequelae among solid organ transplant recipients: insights from the Omicron period. Abstract #A017. Presented at the American Transplant Congress 2024; June 1-5, 2024; Philadelphia, Pennsylvania.