The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.
In patients who are solid organ transplant recipients (SOTR), researchers found an increased incidence of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality among those with SARS-CoV-2 infection compared with those with influenza, non-SARS-CoV-2, or respiratory syncytial virus (RSV), according to research presented at IDWeek, held virtually from September 29 to October 3, 2021.
The SARS-CoV-2 pandemic has shown worse outcomes in patients who are SOTRs. However, these outcomes, as well as the clinical differences between SARS-CoV-2 and other respiratory viruses, have not been well defined for patients who are SOTRs. To correct this knowledge gap, investigators conducted a retrospective cohort study between January 2017 and October 2020 to assess the clinical characteristics and outcomes of both inpatient and outpatient adult SOTRs who were positive for either SARS-CoV-2 infection, non-SARS-CoV-2 coronavirus, RSV, or influenza. Positive results were determined with specimens collected via nasopharyngeal swab or bronchoalveolar lavage and subsequent polymerase chain reaction (PCR) testing. The follow-up period was up to 3 months. Lower respiratory tract infection (LRTI) was defined as new pulmonary infiltrates with or without symptoms. Log rank testing and Fischer exact testing were performed for statistical analyses.
During the cohort study, 157 patients with SARS-CoV-2 infection, 72 with non-SARS-CoV-2 coronavirus, 100 with influenza, and 50 with RSV infections were identified. No statistically significant differences were observed in regard to secondary infections between patients with SARS-CoV-2 infection vs those with non-SARS-CoV-2 coronavirus and influenza (P =.25, 0.56), respectively; however, statistically significant differences were observed between those with SARS-CoV-2 infection and those with RSV (P =.0009).
LRTIs were more prevalent among patients with SARS CoV-2 infection when compared with those with either non-SARS-CoV-2 coronavirus (P =.03), influenza (P =.0001), or RSV (P =.003). Patients with SARS-CoV-2 infection had increased ICU admissions compared with those with either non-SARS-CoV-2 coronavirus (P =.01), influenza (P =.0001), or RSV (P =.007). The rates of IMV were also increased among patients with SARS-CoV-2 infection compared with those with either non-SARS-CoV-2 coronavirus (P =.01), influenza (P =.01), or RSV (P =.03). In the time to event analysis, the investigators found that patients with SARS-CoV-2 infection were at increased risk of mortality compared with those with either non-SARS-CoV-2 coronavirus, influenza, or RSV (P =.01)
The investigators concluded, “we found higher incidence of ICU admission, mechanical ventilation, and mortality among SARS CoV-2 SOTR vs other respiratory viruses. To validate these results, multicenter study is warranted.”
Mendoza M, Gabriel M, Raja M, et al. Comparison between SARS-Cov-2, non-SARS-Cov-2 coronavirus, influenza and RSV infections among solid organ transplant recipients. Presented at: IDWeek; September 29 to October 3, 2021. Poster 1347.
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