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Trapani S, Masiero L, Puoti F, Rota MC, Del Manso M, Lombardini L, Riccardo F, Amoroso A, Pezzotti P, Grossi PA, Brusaferro S, Cardillo M. Incidence and outcome of SARS-CoV-2 infection on solid organ transplantation recipients: A nationwide population-based study. Am J Transplant 2021; 21:2509-2521. [PMID: 33278850 PMCID: PMC9906464 DOI: 10.1111/ajt.16428] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/02/2020] [Accepted: 11/24/2020] [Indexed: 01/25/2023]
Abstract
Since February 21 2020, when the Italian National Institute of Health (Istituto Superiore di Sanità-ISS) reported the first autochthonous case of infection, a dedicated surveillance system for SARS-CoV-2-positive (COVID+) cases has been created in Italy. These data were cross-referenced with those inside the Information Transplant System in order to assess the cumulative incidence (CI) and the outcome of SARS-COV-2 infection in solid organ transplant recipients (SOTRs) who are assumed to be most at risk. We compared our results with those of COVID+ nontransplanted patients (Non-SOTRs) with follow-up through September 30, 2020. The CI of SARS-CoV-2 infection in SOTRs was 1.02%, higher than in COVID+ Non-SOTRs (0.4%, p < .05) with a greater risk in the Lombardy region (2.89%). The CI by type of organ transplant was higher for heart (CI 1.57%, incidence rate ratio [IRR] 1.36) and lower for liver (CI 0.63%, IRR 0.54). The 60-day CI of mortality was 30.6%, twice as much that of COVID+ Non-SOTRs (15.4%) with a 60-day gender and age adjusted odds ratio (adjusted-OR) of 3.83 for COVID+ SOTRs (95% confidence interval [3.03-4.85]). The lowest 60-day adjusted-OR was observed in liver SOTRs (OR 0.46, 95% confidence interval [0.25-0.86]). More detailed studies on disease management and evolution will be necessary in these patients at greater risk of COVID-19.
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Affiliation(s)
- Silvia Trapani
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy,Correspondence Silvia Trapani, Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy.
| | - Lucia Masiero
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Puoti
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Maria C. Rota
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Letizia Lombardini
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Antonio Amoroso
- Department of Medical Sciences, University of Turin and University Hospital “Città della Salute e della Scienza” of Turin, Turin, Italy
| | - Patrizio Pezzotti
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Massimo Cardillo
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
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