Table 1.
Characteristics of Solid Organ Transplant Recipients Hospitalized for Coronavirus Disease 2019
| Characteristic, n (%) | Followed Through Day 28 (n = 1117) | Followed Through Day 90 (n = 936) |
|---|---|---|
| Men | 694 (62.2) | 581 (62.1) |
| Age >65 years | 343 (30.7) | 290 (31.0) |
| Median age (interquartile range), years | 59 (49–67) | 60 (49–67) |
| Black race | 370 (34.8) | 287 (32.0) |
| Hispanic or Latinx ethnicity | 338 (31.3) | 298 (33.0) |
| Transplant within 2 years | 368 (33.8) | 323 (35.4) |
| Organa | ||
| Kidney | 693 (62.0) | 567 (60.6) |
| Liver | 157 (14.1) | 134 (14.3) |
| Heart | 137 (12.3) | 114 (12.2) |
| Lung | 127 (11.4) | 119 (12.7) |
| Other | 3 (0.3) | 2 (0.21) |
| Comorbidities | ||
| Diabetes mellitus | 563 (50.4) | 475 (50.8) |
| Body mass index ≥30 kg/m2 | 382 (35.8) | 318 (35.7) |
| Chronic kidney disease or end-stage renal disease | 406 (36.4) | 325 (35.7) |
| Heart failure | 69 (6.2) | 57 (6.1) |
| Chronic lung disease | 74 (6.6) | 61 (6.5) |
| Baseline immunosuppression | ||
| Any CNI | 1024 (91.7) | 850 (90.8) |
| Any antimetabolite | 836 (74.8) | 709 (75.8) |
| Any corticosteroid | 818 (73.2) | 682 (72.9) |
| CNI, antimetabolite, steroids | 589 (52.7) | 498 (53.2) |
| Any mammalian target of rapamycin inhibitor | 65 (5.8) | 54 (5.8) |
| Recent intensive immunosuppressionb | 67 (6.0) | 63 (6.8) |
| Time period of diagnosis | ||
| Early 2020 (before 20 June 2020) | 593 (53.1) | 458 (48.9) |
| Late 2020 (on or after 20 June 2020) | 411 (36.8) | 371 (39.6) |
| Unknown | 113 (10.1) | 107 (11.4) |
| Surrogate markers of illness severity at presentation | ||
| Abnormal chest imagingc | 835 (82.3) | 689 (81.9) |
| Lymphopenia (absolute lymphocyte count <0.5 × 109/L) | 325 (31.5) | 275 (32.3) |
Among the 1117 patients followed through day 28: sex was missing for 1; race was missing for 54; ethnicity was missing for 38; year of most recent transplant was missing for 28; body mass index (BMI) was missing for 50; and chest imaging was not performed for 102. Presenting absolute lymphocyte count was missing for 85 patients. Among the 936 patients followed through day 90: sex was missing for 1; race was missing for 38; ethnicity was missing for 27; year of most recent transplant was missing for 22; BMI was missing for 46; time period of diagnosis was missing for 107; chest imaging was missing or not performed for 95; and absolute lymphocyte count at presentation was missing for 80. Patient race and ethnicity were collected as distinct variables and reported by the contributor based on observations or documentation in the electronic medical record. Race and ethnicity were collected as part of the registry to characterize the study population.
Abbreviation: CNI, calcineurin inhibitor.
Among the 1117 patients followed through day 28: kidney includes 19 kidney–pancreas recipients; liver includes 34 liver–kidney recipients, 1 liver–pancreas–small bowel recipient, and 1 liver–kidney–small bowel–stomach recipient; heart includes 15 heart–kidney recipients and 1 heart–kidney–small bowel recipient; lung includes 3 heart–lung, 1 lung–liver recipients, and 1 lung–kidney–small bowel recipient; other includes 2 small bowel and 1 vascular composite allograft recipients. Among the 926 patients followed through day 90: kidney includes 15 kidney–pancreas recipients; liver includes 23 liver–kidney recipients, 1 liver–pancreas–small bowel recipient, and 1 liver–pancreas–small bowel–stomach recipient; heart includes 14 heart–kidney recipients and 1 heart–kidney–small bowel recipient; lung includes 2 heart–lung recipients, 1 lung–liver recipient, and 1 lung–kidney–islet cell recipient.
Recent intensive immunosuppression refers to agents with significant T-cell, B-cell, or immunoglobulin depleting activity given within the 3 months prior to severe acute respiratory syndrome coronavirus 2 diagnosis. For the 1117 patients followed through day 28, agents included antithymocyte globulin (n = 37); alemtuzumab (n = 2); basiliximab (n = 17); pulse steroids, defined as equivalent of ≥500 mg methylprednisolone for ≥3 days (n = 24); rituximab (n = 4); plasmapheresis (n = 1); and bortezomib (n = 1). Among the 936 patients followed through day 90, agents included antithymocyte globulin (n = 34); alemtuzumab (n = 2); basiliximab (n = 17); pulse steroids, defined as equivalent of ≥500 mg methylprednisolone for ≥3 days (n = 21); rituximab (n = 4); plasmapheresis (n = 1); and bortezomib (n = 1).
Abnormal chest imaging findings on X-ray or computed tomography included lobar consolidation, multifocal or patchy opacities, including ground glass, interstitial abnormalities, or other findings deemed clinically significant by the contributing provider.