Burden of Respiratory Virus Infections in Solid-Organ Transplant Recipients: A Nationwide Multi-Season Cohort Study
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 December 12, 2024.« Back to 2019 American Transplant Congress