COVID-19 in Solid Organ Transplantation: Results of the National COVID Cohort Collaborative

Amanda J. Vinson, Gaurav Agarwal, Ran Dai, Alfred J. Anzalone, Stephen B. Lee, Evan French, Amy Olex, Vithal Madhira, Roslyn B. Mannon

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Background. Coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality in solid organ transplant (SOT) recipients. The National COVID Cohort Collaborative was developed to facilitate analysis of patient-level data for those tested for COVID-19 across the United States. Methods. In this study, we identified a cohort of SOT recipients testing positive or negative for COVID-19 (COVID+ and COVID-, respectively) between January 1, 2020, and November 20, 2020. Univariable and multivariable logistic regression were used to determine predictors of a positive result among those tested. Outcomes following COVID-19 diagnosis were also explored. Results. Of 18 121 SOT patients tested, 1925 were positive (10.6%). COVID+ SOT patients were more likely to have a kidney transplant and be non-White race. Comorbidities were common in all SOT patients but significantly more common in those who were COVID+. Of COVID+ SOT, 42.9% required hospital admission. COVID+ status was the strongest predictor of acute kidney injury (AKI), rejection, and graft failure in the 90 d after testing. A total of 40.9% of COVID+ SOT experienced a major adverse renal or cardiac event, 16.3% experienced a major adverse cardiac event, 35.3% experienced AKI, and 1.5% experienced graft loss. Conclusions. In the largest US cohort of COVID+ SOT recipients to date, we identified patient factors associated with the diagnosis of COVID-19 and outcomes following infection, including a high incidence of major adverse renal or cardiac event and AKI.

Original languageEnglish (US)
Article numbere775
JournalTransplantation Direct
Issue number11
StatePublished - Oct 6 2021

ASJC Scopus subject areas

  • Transplantation


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