TABLE 1.
Baseline characteristics of hospitalized SOTR with COVID-19
| Features of hospitalized SOTR | Lung (n = 120) | Non-lung (n = 961) | p value |
|---|---|---|---|
| Mean age in years (SD) | 60.6 (13.0) | 961 (57.0) | .005 |
| Age >65 years, n (%) | 48 (40.0) | 289 (30.0) | .03 |
| Mean day of hospitalization relative to first positive SARS-CoV–2 test (SD) | 2.3 (4.8) | 2.3 (4.8) | |
| Male, n (%) | 62 (51.7) | 610 (63.5) | .01 |
| Race, n (%) | .05 | ||
| Indigenous peoples | 0 (0.0) | 18 (1.9) | |
| Asian | 3 (2.5) | 44 (4.6) | |
| Black or African Descent | 29 (24.2) | 328 (34.1) | |
| White or Caucasian | 75 (62.5) | 498 (51.8) | |
| Pacific Islander | 0 (0.0) | 4 (0.4) | |
| Other or unknown | 13 (10.8) | 69 (7.2) | |
| Geographic location, n (%) | <.001 | ||
| Northeastern United States | 28 (23.3) | 298 (23.3) | |
| Midwestern United States | 12 (10.0) | 91 (9.5) | |
| Southern United States | 33 (27.5) | 319 (33.2) | |
| Western United States | 42 (35.0) | 181 (18.8) | |
| International | 5 (4.2) | 28 (2.9) | |
| Organ n (%)a | |||
| Heart | — | 131 (13.6) | |
| Liver | — | 154 (16.0) | |
| Kidney | — | 72 (70.0) | |
| Other | — | 3 (0.3) | |
| Single lung transplant | 34 (28.6) | — | |
| Comorbidities, n (%) | |||
| Hypertension | 60 (50.0) | 776 (80.8) | <.001 |
| Diabetes mellitus | 56 (46.7) | 489 (50.9) | .38 |
| Heart failure | 8 (6.7) | 58 (6.0) | .79 |
| Obesity (BMI ≥30 kg/m2)b | 29 (24.8) | 347 (37.2) | .01 |
| Chronic kidney disease | 62 (51.7) | 336 (35.0) | <.001 |
| Coronary artery disease | 23 (19.2) | 171 (17.8) | .71 |
| Chronic lung disease | — | 55 (5) | |
| Chronic lung allograft dysfunction | 16 (13.3) | — | |
| Immunosuppression, n (%)c,d,e,f | |||
| Recent induction therapy, n (%) | 1 (0.8) | 62 (6.5) | .01 |
| CNI, anti-metabolite, steroids | 84 (70.0) | 485 (50.5) | <.001 |
| Any CNI containing regimen | 117 (97.5) | 878 (91.4) | .02 |
| Any anti-metabolite containing regimen | 86 (71.7) | 727 (75.7) | .34 |
| Any steroid containing regimen | 117 (97.5) | 674 (70.2) | <.001 |
| Any mTOR inhibitor containing regimen | 9 (7.5) | 52 (5.4) | <.001 |
| Covid–19 treatments and interventions | |||
| Reduction in immunosuppressiongh | 64 (56.6) | 686 (74.1) | <.001 |
| Corticosteroids (≥6-mg dexamethasone equivalents/day) | 67 (55.8) | 304 (31.6) | <.001 |
| Remdesivir | 65 (54.2) | 253 (26.3) | <.001 |
| Convalescent plasma | 34 (28.3) | 158 (16.4) | .001 |
Abbreviations: BMI, body mass index; CNI, calcineurin inhibitor; mTOR, mammalian target of rapamycin; SOTR, solid organ transplant recipients; SD, standard deviation.
Lung includes 1 lung/liver, 2 heart/lung recipients and 1 lung/kidney/islet cell. Heart includes 14 heart/kidney and 1 heart/kidney/small bowel recipients. Liver includes 34 liver/kidney and 2 liver/pancreas/small bowel. Kidney includes 18 kidney/pancreas recipients. Other includes 1 vascular composite allograft and 2 small bowel recipients.
Type of lung transplant (single vs. double) was available for 119 lung recipients.
BMI was available for 117 lung and 932 non-lung recipients.
Induction of immunosuppression includes receipt of any of the following agents in the three months prior to Covid-19 diagnosis: antithymocyte globulin (35 non-lung, 0 lung), alemtuzumab (2 non-lung, 0 lung), basiliximab (15 non-lung, 1 lung), ≥ 500mg methylprednisolone/day × 3 or more days (21 non-lung, 0 lung), rituximab (4 lung, 0 non-lung), plasmapheresis (1 lung, 0 non-lung), or bortezomib (1 lung, 0-non-lung). Some patients received more than one induction agent.
CNI in lung recipients: tacrolimus (n = 113), cyclosporine (n = 4). CNI in non-lung recipients: tacrolimus (n = 821), cyclosporine (n = 58).
Antimetabolite in lung recipients: mycophenolate (n = 73), azathioprine (n = 13). Antimetabolite in non-lung recipients: mycophenolate (n = 690), azathioprine (n = 34), leflunomide (n = 4).
Maintenance corticosteroid dose equivalents in lung recipients: ≤20 mg prednisone/day (n = 111), >20 mg prednisone/day (n = 6). Maintenance steroid dose equivalents in non-lung recipients: ≤20 mg prednisone/day (n = 664), >20 mg prednisone/day (n = 30).
Reduction in immunosuppression in lung recipients: hold anti-metabolite (n = 54), decrease anti-metabolite (n = 4), change calcineurin inhibitor goal (n = 13), hold and decrease mTOR inhibitor (n = 2) hold all immunosuppression (n = 2). Reduction in immunosuppression in nonlung recipients: hold anti-metabolite (n = 521), decrease anti-metabolite (n = 86), change calcineurin inhibitor goal (n = 222), hold or decrease mTOR inhibitor (n = 11), delay or withhold belatacept (n = 4), decrease prednisone n = 1), hold all immunosuppression (n = 18). Some patients experienced more than one change.