High Rates of Long-Term COVID-19 Complications in Solid Organ Transplant Recipients

High rates of long-term complications following COVID-19 infection in solid organ transplant recipients suggest additional studies are needed in this patient population.

High rates of mortality, allograft rejection, allograft failure, secondary infection, organ dysfunction, and symptoms suggestive of long COVID-19 infection were observed 2 years after COVID-19 diagnosis in patients who were solid organ transplant (SOT) recipients. These study results were presented at IDWeek 2022, held from October 19 to 23, in Washington, DC.

Researchers conducted a retrospective study to evaluate the prevalence of long-term complications following COVID-19 infection among adults who were SOT recipients. Included patients were hospitalized with COVID-19 infection at a single center between March and May 2020. Outcomes assessed included mortality, allograft rejection, allograft failure, secondary infection, COVID-19 reinfection, complications post-COVID-19 infection, and long COVID-19 symptoms. The follow-up period was 2 years.

Among 117 patients hospitalized with COVID-19 infection during the first wave of the pandemic, 94 were included in the analysis. Of these patients, the median age was 57 (IQR, 48.25-68) years, 62 were men, 39 were White, and the median duration of follow-up after COVID-19 diagnosis was 751 (IQR, 742-760) days.

Following receipt of COVID-19 diagnosis, mortality occurred among 9 patients within 1 year and 14 patients within 2 years. In addition, 21 patients experienced at least 1 episode of allograft rejection and 21 experienced allograft failure.

Secondary infections were observed among 43 patients, of whom 18 were infected with multidrug-resistant organisms and 12 were infected with cytomegalovirus. Other complications following COVID-19 infection observed among the patients included the need for prolonged supplemental oxygen (n=8), new cardiovascular disease (n=25), and new chronic kidney disease or end-stage kidney disease (n=32).

Ongoing study of the impact of these complications will be crucial to improving outcomes in SOT recipients.

Of 11 patients who were reinfected with COVID-19, the median duration between initial infection and reinfection was 603 (IQR, 389-642) days. The most likely causative variant of reinfection was the Omicron variant (n=5), followed by the Delta (n=3) and Alpha (n=3) variants.

The most commonly reported long COVID-19 symptoms included fatigue in 26 patients, dyspnea in 18, and cough in 11. During the study period, 45 patients received 3 or more COVID-19 vaccine doses, 21 received 2 vaccine doses, and 1 patient received 1 vaccine dose. COVID-19 vaccination history was unknown for the remaining 14 patients.

In regard to complications following COVID-19 infection, “Ongoing study of the impact of these complications will be crucial to improving outcomes in SOT recipients,” the researchers concluded.

Disclosures: Some authors reported affiliations with the pharmaceutical industry. Please see the reference for a full list of disclosures.


Burack D, Pereira MR, Verna E. Long-term (2-year) outcomes and complications of COVID-19 in solid organ transplant (SOT) recipients. Presented at: IDWeek 2022; October 19-23; Washington, DC. Poster 2116.