NYMC Faculty Publications
Excess Mortality in COVID-19-Affected Solid Organ Transplant Recipients Across the Pandemic
Author Type(s)
Faculty
DOI
10.1016/j.ajt.2024.03.016
Journal Title
American Journal of Transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
First Page
1495
Last Page
1508
Document Type
Article
Publication Date
8-2024
Department
Surgery
Keywords
Humans, COVID-19, Organ Transplantation, Male, Female, Middle Aged, Transplant Recipients, Prospective Studies, SARS-CoV-2, Aged, Registries, Adult, Japan, Pandemics
Disciplines
Medicine and Health Sciences
Abstract
The excess mortality of coronavirus disease 2019 (COVID-19) solid organ transplant recipients (SOTRs) throughout the pandemic remains unclear. This prospective cohort study based on the Japanese nationwide registry included 1632 SOTRs diagnosed with COVID-19 between February 1, 2020, and July 31, 2022, categorized based on dominant phases of variants of concern (VOCs): Waves 1 to 3 (Beta), 4 (Alpha), 5 (Delta), 6 (Omicron BA.1/BA.2), and 7 (Omicron BA.5). Excess mortality of COVID-19-affected SOTRs was analyzed by calculating standardized mortality ratios (SMRs). Overall, 1632 COVID-19-confirmed SOTRs included 1170 kidney, 408 liver, 25 lung, 20 heart, 1 small intestine, and 8 multiorgan recipients. Although disease severity and all-cause mortality decreased as VOCs transitioned, SMRs of SOTRs were consistently higher than those of the general population throughout the pandemic, showing a U-shaped gap that peaked toward the Omicron BA.5 phase; SMR (95% CI): 6.2 (3.1-12.5), 4.0 (1.5-10.6), 3.0 (1.3-6.7), 8.8 (5.3-14.5), and 21.9 (5.5-87.6) for Waves 1 to 3 (Beta), Wave 4 (Alpha), Wave 5 (Delta), Wave 6 (Omicron BA.1/2), and Wave 7 (Omicron BA.5), respectively. In conclusion, COVID-19 SOTRs had greater SMRs than the general population across the pandemic. Vaccine boosters, immunosuppression optimization, and other protective measures, particularly for older SOTRs, are paramount.
Recommended Citation
Yamanaga, S., Shimata, K., Ohfuji, S., Yoshikawa, M., Natori, Y., Hibi, T., Yuzawa, K., Egawa, H., Japan Society for Transplantation COVID-19 Registry Study Group., & Sogawa, H. (2024). Excess Mortality in COVID-19-Affected Solid Organ Transplant Recipients Across the Pandemic. American Journal of Transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 24 (8), 1495-1508. https://doi.org/10.1016/j.ajt.2024.03.016
