Risk Factors Associated with ICU Admission and Death in Patients Hospitalized with COVID-19 Differ Between Solid Organ Transplant and Non-Solid Organ Transplant Patients
David Geffen School of Medicine at UCLA, Los Angeles, CA
Meeting: 2022 American Transplant Congress
Abstract number: 685
Keywords: COVID-19, Lung infection, Outcome, Risk factors
Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: All Infections (Excluding Kidney & Viral Hepatitis) I
Session Type: Poster Abstract
Date: Saturday, June 4, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Despite the large numbers of reports on patient risk factors for poor clinical outcomes with COVID-19, little is known about how these risks may differ for solid organ transplant (SOT) recipients versus non-SOT (NSOT) patients.
*Methods: We reviewed demographic and comorbid conditions in a cohort of SOT (n=129) and NSOT patients (n=708) admitted to our center for COVID-19 between December 2019 and February 2021. Patient characteristics were compared between groups using the t-test or chi-square test. Univariable and multivariable (stepwise reduced) logistic regression models were constructed for our outcomes of interest.
*Results: Patient age and sex were similar between SOT and NSOT cohorts. However, SOT patients were more likely to be of Hispanic ethnicity (64% v. 39%, p<0.001). Both SOT and NSOT had similar incidence of neurologic conditions (23% and 21%, p=0.476), but SOT patients were more likely to have comorbid conditions including diabetes mellitus, cardiovascular condition, or lung disease (all p<0.001). Several clinical factors were associated with ICU admission in NSOT patients, including patient age, diabetes, cardiac disease, neurologic disease, obesity, and hepatobiliary disease (all p < 0.05). In contrast, only cardiac disease was associated with ICU admission for SOT patients (p=0.010). Multivariable analysis of factors associated with increased mortality revealed that neurologic condition (OR 3.0, 95% CI 0.8-11.4) and lung disease (OR 3.5, 95% CI 0.7-18.2) were significant for SOT patients in a model including age, sex, and other comorbid conditions. In contrast, for NSOT patients, history of a neurologic condition (OR 2.3, 95% CI 1.3-4.0) and age >65 (OR 4.2, 95% CI 2.1-8.7) were significantly associated with death in a multivariate analysis.
*Conclusions: It has been previously unclear whether risk factors associated with poor outcomes in NSOT patients with COVID-19 will be similarly important in SOT recipients. Our analysis demonstrated different risk associations in contemporaneous patient cohorts at a single academic center. This observation suggests that SOT-specific approaches for risk stratification would be beneficial for patient evaluation and triage.
To cite this abstract in AMA style:
Schaenman J, Byford H, Grogan TR, Motwani Y, Beaird O, Kamath M, Lum E, Meneses K, Sayah D, Vucicevic D, Saab S. Risk Factors Associated with ICU Admission and Death in Patients Hospitalized with COVID-19 Differ Between Solid Organ Transplant and Non-Solid Organ Transplant Patients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-factors-associated-with-icu-admission-and-death-in-patients-hospitalized-with-covid-19-differ-between-solid-organ-transplant-and-non-solid-organ-transplant-patients/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress