1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients

BACKGROUND: COVID-19 disease became a global health care crisis and was declared pandemic by WHO in March 2020. Little is known how the immunosuppressive medications impact the mortality rate in Solid Organ Transplant (SOT) recipients. There is also minimal data regarding the incidence of transplant...

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Autores principales: Sabunwala, Suhel A, Cornelius, Tuhina, Aslam, Sadaf, Alrabaa, Sally, Kumar, Ambuj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751548/
http://dx.doi.org/10.1093/ofid/ofac492.932
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author Sabunwala, Suhel A
Cornelius, Tuhina
Aslam, Sadaf
Alrabaa, Sally
Kumar, Ambuj
author_facet Sabunwala, Suhel A
Cornelius, Tuhina
Aslam, Sadaf
Alrabaa, Sally
Kumar, Ambuj
author_sort Sabunwala, Suhel A
collection PubMed
description BACKGROUND: COVID-19 disease became a global health care crisis and was declared pandemic by WHO in March 2020. Little is known how the immunosuppressive medications impact the mortality rate in Solid Organ Transplant (SOT) recipients. There is also minimal data regarding the incidence of transplanted graft failure or rejection that could be attributed to the COVID-19 infection itself or its complications and management. Our study aims to investigate the management of COVID-19 infection, outcome of the infection, transplant failure and rejection rates in SOT recipients. METHODS: We conducted a retrospective cohort study of all consecutive SOT recipients who were admitted to our transplant center from March 2020 to April 2021 with COVID-19 infection. Data was collected from the electronic medical records after receiving Institutional Review Board approval. [Figure: see text] [Figure: see text] RESULTS: A total of 135 patients met the inclusion criteria. After the diagnosis of COVID -19 infection, 31% recipients had decrease in the dose of immunosuppressive medications (change group) and 69% had no changes in the dose (no change group). Out of the 73 Kidney Transplant recipients 33% were in the change group compared to 14% of liver, 25% of heart and 27% of lung transplant recipients. Of the total 42 recipients in the change group, 28.6% required Intensive Care Unit (ICU) level care significantly higher compared to 7.5% in the no change group (p-value < 0.005). Mechanical ventilation was required in 14.3% of the patients in the change group and 6.5% in the no change group (p-value < 0.5). Out of the total, 85.7% patients in the change group survived compared to 94.6% in the no change group (p-value < 0.1). Overall, the transplant rejection rate was higher in the change group compared to the no change group (p-value < 0.5). [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: Our study showed a significantly higher ICU admission rate and mortality in SOT recipients who had their immune suppression reduced at the time of COVID-19 diagnosis. The same group also had a higher risk of rejection of transplanted graft. More studies with larger sample size needs to be done to further understand the management of immunosuppressive drugs in the SOT recipients with COIVD-19 infection. DISCLOSURES: All Authors: No reported disclosures.
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spelling pubmed-97515482022-12-16 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients Sabunwala, Suhel A Cornelius, Tuhina Aslam, Sadaf Alrabaa, Sally Kumar, Ambuj Open Forum Infect Dis Abstracts BACKGROUND: COVID-19 disease became a global health care crisis and was declared pandemic by WHO in March 2020. Little is known how the immunosuppressive medications impact the mortality rate in Solid Organ Transplant (SOT) recipients. There is also minimal data regarding the incidence of transplanted graft failure or rejection that could be attributed to the COVID-19 infection itself or its complications and management. Our study aims to investigate the management of COVID-19 infection, outcome of the infection, transplant failure and rejection rates in SOT recipients. METHODS: We conducted a retrospective cohort study of all consecutive SOT recipients who were admitted to our transplant center from March 2020 to April 2021 with COVID-19 infection. Data was collected from the electronic medical records after receiving Institutional Review Board approval. [Figure: see text] [Figure: see text] RESULTS: A total of 135 patients met the inclusion criteria. After the diagnosis of COVID -19 infection, 31% recipients had decrease in the dose of immunosuppressive medications (change group) and 69% had no changes in the dose (no change group). Out of the 73 Kidney Transplant recipients 33% were in the change group compared to 14% of liver, 25% of heart and 27% of lung transplant recipients. Of the total 42 recipients in the change group, 28.6% required Intensive Care Unit (ICU) level care significantly higher compared to 7.5% in the no change group (p-value < 0.005). Mechanical ventilation was required in 14.3% of the patients in the change group and 6.5% in the no change group (p-value < 0.5). Out of the total, 85.7% patients in the change group survived compared to 94.6% in the no change group (p-value < 0.1). Overall, the transplant rejection rate was higher in the change group compared to the no change group (p-value < 0.5). [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: Our study showed a significantly higher ICU admission rate and mortality in SOT recipients who had their immune suppression reduced at the time of COVID-19 diagnosis. The same group also had a higher risk of rejection of transplanted graft. More studies with larger sample size needs to be done to further understand the management of immunosuppressive drugs in the SOT recipients with COIVD-19 infection. DISCLOSURES: All Authors: No reported disclosures. Oxford University Press 2022-12-15 /pmc/articles/PMC9751548/ http://dx.doi.org/10.1093/ofid/ofac492.932 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Sabunwala, Suhel A
Cornelius, Tuhina
Aslam, Sadaf
Alrabaa, Sally
Kumar, Ambuj
1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title_full 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title_fullStr 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title_full_unstemmed 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title_short 1092. Management of Transplant Graft and Role of Immunosuppression in the Outcome of Covid-19 Infection in Solid Organ Transplant Recipients
title_sort 1092. management of transplant graft and role of immunosuppression in the outcome of covid-19 infection in solid organ transplant recipients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751548/
http://dx.doi.org/10.1093/ofid/ofac492.932
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