SARS-CoV-2 infection and early mortality of wait-listed and solid organ transplant recipients in England: a national cohort study

Authors: Ravanan, Rommel ;

O'Callaghan, Chris J.;

Mumford, Lisa;

Ushiro-Lumb, Ines;

Thorburn, Douglas;

Casey, John;

Friend, Peter J.;

Parameshwar, Jayan;

Currie, Ian;

Burnapp, Lisa;

Baker, Richard;

Dudley, Jan;

Oniscu, Gabriel C;

Berman, Marius;

Asher, John;

Harvey, Dan;

Manara, Alex;

Manas, Derek M;

Gardiner, Dale;

Forsythe, John

Source: American Journal of Transplantation

Full text

: https://doi.org/10.1111/ajt.16247

Abstract

Patients wait-listed for and recipients of solid organ transplants (SOT) are perceived to have a higher risk of contracting SARS-CoV-2 and death; however, definitive epidemiological evidence is lacking. In a comprehensive national cohort study enabled by linkage of the UK transplant registry and Public Health England and NHS Digital Tracing services we examined the incidence of laboratory confirmed SARS-CoV-2 infection and subsequent mortality in patients on the active waiting list for a deceased donor SOT and recipients with a functioning SOT as of 1st February 2020 with follow up to 20th May 20202. Univariate and multivariable techniques were used to compare differences between groups and to control for case-mix. 197 (3·8%) of the 5,184 wait-listed patients and 597 (1·3%) of the 46,789 SOT recipients tested positive for SARS-CoV-2. Mortality after testing positive for SARS-CoV-2 was 10·2% (20/197) for wait-listed patients and 25·8% (154/597) for SOT recipients. Increasing recipient age was the only variable independently associated with death after positive SARS-CoV-2 test. Of the 1004 transplants performed in 2020, 41 (4·1%) recipients have tested positive for SARS-CoV-2 with 8 (0·8%) deaths reported by 20th May. These data provide evidence to support decisions on the risks and benefits of SOT during the COVID-19 pandemic.

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Ravanan, R., O'Callaghan, C., Mumford, L., Ushiro-Lumb, I., Thorburn, D., Casey, J., Friend, P., Parameshwar, J., Currie, I., Burnapp, L., Baker, R., Dudley, J., Oniscu, G., Berman, M., Asher, J., Harvey, D., Manara, A., Manas, D., Gardiner, D. & Forsythe, J. 2020, 'SARS-CoV-2 infection and early mortality of wait-listed and solid organ transplant recipients in England: a national cohort study', American Journal of Transplantation, 20(11), pp. 3008-3018. https://doi.org/10.1111/ajt.16247

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DOI: https://doi.org/10.1111/ajt.16247

Repository URI: https://www.research.ed.ac.uk/en/publications/fdda2ae1-292a-4795-9234-7a4aeda7a36b