Introduction
The solid organ transplant (SOT) population is uniquely vulnerable to upper respiratory infections (URI), given their immunosuppressed state. SOT recipients who present with a fever and URI symptoms present a clinical challenge in the COVID-19 era.
Methods
We evaluated data from a 7-hospital healthcare system of all SOT recipients with clinical suspicion for COVID-19 infection from March 30 to May 7, 2020 in the early phase of the COVID-19 pandemic. We assessed relevant demographic, clinical, and laboratory data during their hospital course and on follow-up. We compared characteristics between confirmed COVID-19 SOT cases (COVID19+) and COVID-19 negative SOT patients (COVID19-) who initially presented as a person under investigation (PUI).
Results
During the study time period, 69 SOT PUI patients were included in the analysis; 53 COVID19- and 16 COVID19+. The overall cohort included 43 kidney, 10 liver, 13 heart, and 3 combined transplants. COVID19+ patients did not differ from COVID19- patients in terms of their baseline demographic characteristics, comorbid conditions, or blood work. Clinically, COVID19+ recipients endorsed ageusia and anosmia at levels that approached (due to small sample size) a significantly higher prevalence (p = 0.05 [1]). Mortality was significantly higher (45.5%) for COVID19+ SOT recipients (p < 0.05). In the COVID19- cohort, respiratory infections (22.6%) were the primary source of symptoms.
Conclusion
COVID19+ SOT recipients demonstrate ageusia and anosmia with higher frequency than COVID19- recipients. COVID-19 remains a highly lethal disease in the SOT recipient, underscoring the importance of early identification and treatment.