TABLE 1.
Characteristics of hospitalized and nonhospitalized transplant recipients
| Characteristics | Total transplant recipients (n = 47) | Hospitalized transplant recipients (n = 35) | Nonhospitalized transplant recipients (n = 12) | P value |
|---|---|---|---|---|
| Demographics | ||||
| Median age (IQR) - y | 61 (52-70) | 62 (48-71) | 59 (55-67) | .92 |
| Male sex – no. (%) | 32 (68.1) | 23 (65.7) | 9 (75) | .73 |
| Black race – no. (%) | 39 (83.0) | 30 (85.7) | 9 (75) | .40 |
| Median BMI (IQR) - kg/m2 | 27.4 (25.5-33) | 27.3 (24.9-33) | 27.5 (26.8-32.2) | .95 |
| Coexisting conditions – no. (%) | ||||
| Chronic obstructive pulmonary disease | 7 (14.9) | 6 (17.1) | 1 (8.3) | .66 |
| Chronic kidney disease | 42 (89.4) | 31 (88.6) | 11 (91.7) | 1.00 |
| Congestive heart failure | 11 (23.4) | 10 (28.6) | 1 (8.3) | .24 |
| Coronary artery disease | 6 (12.8) | 5 (14.29) | 1 (8.3) | 1.00 |
| Diabetes | 32 (68.1) | 23 (65.7) | 9 (75) | .73 |
| Hypertension | 44 (93.6) | 33 (94.3) | 11 (91.7) | 1.00 |
| Malignancy | 4 (8.5) | 4 (11.4) | 0 (0) | .55 |
| Smoking history | 11 (23.4) | 9 (25.7) | 2 (16.7) | .70 |
| Type of organ transplant (%)a | ||||
| Kidney | 38 (80.9) | 26 (74.3) | 12 (100) | .49 |
| Liver | 1 (2.1) | 0 (0) | 1 (8.3) | |
| Heart | 5 (10.6) | 5 (14.3) | 0 (0) | |
| Lung | 4 (8.5) | 4 (11.4) | 0(0) | |
| Pancreas | 1 (2.1) | 1 (2.9) | 0 (0) | |
| Exposure history | ||||
| Contact with person with COVID-19 – no (%) | 12 (25.5) | 10 (28.6) | 2 (16.7) | .70 |
| Symptoms | ||||
| Altered mentation – no. (%) | 4 (8.5) | 4 (11.4) | 0 (0) | .56 |
| Cough – no. (%) | 32 (68.1) | 22(62.9) | 10 (83.3) | .29 |
| Diarrhea – no. (%) | 26 (55.3) | 19 (54.3) | 7 (58.3) | .81 |
| Fatigue – no. (%) | 21 (44.7) | 16 (45.7) | 5 (41.7) | .81 |
| Fever – no. (%) | 29 (61.7) | 23 (65.7) | 6 (50) | .49 |
| Myalgia – no. (%) | 20 (42.6) | 17 (48.6) | 3 (25) | .15 |
| Shortness of breath – no. (%) | 28 (59.6) | 24 (68.6) | 4 (33.3) | .04 |
| Median duration from symptom onset to diagnosis (IQR) - d | 7 (3-10) | 7 (3-10) | 7 (3-10) | .76 |
| Laboratory test – median (IQR) | ||||
| White blood cell count (x10-9/L) | 5.6 (4.1 - 8.2) | 5.5 (4.1-8.1) | 6.2 (4.7-9.1) | .72 |
| Absolute lymphocyte count (x10-9/L) | 0.65 (0.40-0.80) | 0.50 (0.3-0.8) | 1.6 (0.8-2.0) | .02 |
| Hemoglobin (g/dL) | 11.9 (10.9-13.2 | 11.9 (10.7-13) | 13.5 (12.4-14.7) | .09 |
| Platelets (g/dL) | 174 (134-258) | 176 (133-261) | 166 (149-225) | .97 |
| C-reactive protein (mg/dL)b | 6.6 (2.2-13.5) | 7.5 (2.2-13.5) | 2.4 (2.4-2.4) | .74 |
| Imaging of the lungsc | ||||
| Abnormal - no. (%) | 32 (68.1) | 29 (82.8) | 3 (25) | .0005 |
| Severity of illness in emergency department | ||||
| Median qSOFA (IQR) | 1 (0-2) | 1 (0.5-2) | 0 (0-0) | .06 |
| Median NEWS (IQR) | 5 (3-8) | 6.5 (4-9) | 2 (0-4) | .0009 |
| Intubated at arrival – no. (%) | 1 (2.1) | 1 (2.9) | — | — |
| Direct admission to ICU – no. (%) | 5 (14.3) | 5 (14.3) | — | — |
| HFH COVID-19 Severity Score | ||||
| Mild – no. (%) | 13 (27.7) | 4 (11.4) | 9 (75) | .0001 |
| Moderate – no. (%) | 31 (65.9) | 28 (80) | 3 (25) | |
| Severe – no (%) | 3 (6.4) | 3 (8.6) | 0 (0) | |
| Changes in immunosuppression (%)d | 32 (69.5) | 28 (82.4) | 4 (33) | .006 |
| Reduction or cessation of antimetabolite | 27 (84) | 23(82) | 4 (100) | .08 |
| Reduction or cessation of CNI | 5 (15) | 5(17) | 0 (0 | — |
| Reduction or cessation of mTOR inhibitor | 1 (3) | 1 (3) | 0 (0) | — |
| Reduction or cessation of belatacept | 1 (3) | 1 (3) | 0 (0) | — |
Abbreviations: BMI, body mass index; CNI, calcineurin inhibitor; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; HFH, Henry Ford Hospital; ICU, intensive care unit; IQR, interquartile ratio; mTOR, mammalian target of rapamycin; NEWS, National Early Warning Score; q SOFA, quick sequential organ assessment.
Three SOT recipients had dual transplant.
Only 1 patient in the transplant nonhospitalized group had CRP level done.
Imaging of the lungs included chest X-ray or a chest computed tomography (CT) scan.
Total of 46 SOT recipients were on immunosuppressive therapy. One hospitalized SOT patient not receiving immunosuppression was excluded. Two patients had CNI reduced in addition to discontinuation of antimetabolite.