Burden of Respiratory Virus Infections in Solid-Organ Transplant Recipients: A Nationwide Multi-Season Cohort Study

M. Mombelli¹, D. Neofytos², J. Aubert¹, C. Benden³, C. Berger³, K. Boggian⁴, A. Egli⁵, P. Gasche², H. Hirsch⁵, C. Hirzel⁶, N. Mueller³, C. Van Delden², O. Manuel¹

¹CHUV, Lausanne, Switzerland, ²HUG, Geneva, Switzerland, ³USZ, Zurich, Switzerland, ⁴KSSG, St. Gallen, Switzerland, ⁵USB, Basel, Switzerland, ⁶ISB, Bern, Switzerland

Meeting: 2019 American Transplant Congress

Abstract number: A348

Keywords: Infection, Lung infection, Morbidity

Session Information

Session Name: Poster Session A: Transplant Infectious Diseases

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Respiratory virus infections (RVI) are common in solid-organ transplant recipients (SOTr) and are caused by a wide range of viruses. However, beside influenza, little is known about the burden of RVI in SOTr. We aimed to study the burden of RVI in a large nationwide multi-season cohort of SOTr including >95% of transplant performed in Switzerland.

*Methods: Infectious episodes were prospectively collected at each study center. For this study, patients transplanted between 05/2008 and 12/2016 were included. Testing for RVI was performed as part of routine practice at each center. Additional clinical information not included in the cohort database was collected through chart review. Univariate logistic regression was used to identify risk factors for severe RVI.

*Results: Among 4023 patients [401 lung transplant (LT) and 3622 non- LT], we identified 750 episodes of microbiologically documented RVI (26% Influenza, 11% Respiratory Syncytial virus, 8% Parainfluenza virus, 5% Human metapneumovirus, 36% Rhinovirus, 11% Coronavirus, 2% Adenovirus, 1% Bocavirus) in 442/4023 patients (40% of LT and 8% of non-LT). Overall incidence was 47.5 cases per 1000 person-year (95% CI 44.2-51). Lower respiratory tract infection and pneumonia were diagnosed in 248/607 (41%) and 146/342 (43%) RVI respectively. Microbiologically-confirmed bacterial and fungal coinfection occurred in 7.5% and 3.6% RVI. Hospital and Intensive Care Unit (ICU) admission-rates were 35% and 4%. 30-day mortality was 1%. Influenza was associated with ICU admission (OR 2.2; 95%CI 1.1-4.7; p=0.035), as compared to other RVI. RVI within 6 months post-transplant (OR 1.9; 95% CI 0.89-4.1; P=0.096) and nosocomial infection (OR 2.27; 95% CI 0.97-5.3; P=0.059) were non-significantly associated with ICU admission.

*Conclusions: RVI are associated with important morbidity in SOT recipients. Higher incidence in LT is probably explained by more frequent testing for RVI in this population. Influenza, infection early after transplant and nosocomial acquisition were associated with severe infection.

To cite this abstract in AMA style:

Mombelli M, Neofytos D, Aubert J, Benden C, Berger C, Boggian K, Egli A, Gasche P, Hirsch H, Hirzel C, Mueller N, Delden CVan, Manuel O. Burden of Respiratory Virus Infections in Solid-Organ Transplant Recipients: A Nationwide Multi-Season Cohort Study [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/burden-of-respiratory-virus-infections-in-solid-organ-transplant-recipients-a-nationwide-multi-season-cohort-study/. Accessed November 22, 2024.

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