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

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).

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.