tetano
Editor, Senior Moderator
Clin Transplant
. 2026 Oct;40(10):e70723.
doi: 10.1111/ctr.70723.
Beatrice Z Sim 1 2 3 , Julie M Steinbrink 2 , Madeleine R Heldman 2 , Arthur W Baker 2 , Julia A Messina 2 , Sana Arif 2 , Bin Ni 2 , Patrick C K Tam 2 , Manuela Carugati 2 , Jordan Mah 2 , Matthew Goodwin 2 , Ilan S Schwartz 2 , Monica A Slavin 1 3 , Michelle K Yong 1 3 , Cameron R Wolfe 2
Affiliations Expand
Introduction: Effective treatment and prevention for respiratory viral infections (RVI) in solid organ transplant recipients (SOTR) are lacking; clinical differences in COVID-19 and non-COVID-19 (ncRVI) post-omicron are unknown. We compared severity and outcomes across SOT groups.
Methods: A single-center retrospective study of health system RVI in adult SOTR during 2022-2023 was conducted.
Results: Overall, 520 RVI episodes in 504 patients were included: 488 had 1 episode and 16 had 2 episodes. Lung, kidney, and heart transplant recipients comprised of 40.9%, 34.3%, and 20.8% of the cohort. There were 352 episodes of COVID-19 RVI and 148 ncRVI. All-cause and RVI-related hospitalization were comparable between COVID-19 and ncRVI (47.7% vs. 43.9%, p = 0.50; 32.1% vs. 31.1%, p = 0.91 respectively). Oxygen supplementation occurred in 11.9% of COVID-19 RVI and 11.5% of ncRVI with a maximum requirement (median, IQR) of 4.0 (2.0-18.8) and 2.0 (2.0-3.0) liters respectively (p = 0.005). Intensive care unit (ICU) admission occurred in 7.1% and 6.1%; non-invasive ventilation (NIV) in 2.3% and 4.1%; mechanical ventilation (I&V) in 4.0% and 2.0%; and inotropic/vasopressor support in 1.7% and 1.4%, for COVID-19 versus nCRVI, respectively. Patients with COVID-19 had ongoing symptoms in 16.8%, 10.2%, and 2.6% at 30 days, 3 month, and 12 month follow up respectively, compared with 16.9%, 4.7%, and 2.0% in ncRVI. Twelve-month mortality, rejection and graft dysfunction were similar between groups.
Conclusions: COVID-19 and ncRVI pose significant and comparable risk to SOTR in this post-omicron era, in hospitalization, oxygen requirement, and persistent symptoms. Treatment and prevention should be prioritized in this population.
Keywords: COVID‐19; respiratory viral infections; solid organ recipients.
. 2026 Oct;40(10):e70723.
doi: 10.1111/ctr.70723.
Comparing the Post-Omicron Impact of COVID-19 and Non-COVID-19 Respiratory Viral Infections in Solid Organ Transplant Recipients
Beatrice Z Sim 1 2 3 , Julie M Steinbrink 2 , Madeleine R Heldman 2 , Arthur W Baker 2 , Julia A Messina 2 , Sana Arif 2 , Bin Ni 2 , Patrick C K Tam 2 , Manuela Carugati 2 , Jordan Mah 2 , Matthew Goodwin 2 , Ilan S Schwartz 2 , Monica A Slavin 1 3 , Michelle K Yong 1 3 , Cameron R Wolfe 2
Affiliations Expand
- PMID: 42905942
- DOI: 10.1111/ctr.70723
Abstract
Introduction: Effective treatment and prevention for respiratory viral infections (RVI) in solid organ transplant recipients (SOTR) are lacking; clinical differences in COVID-19 and non-COVID-19 (ncRVI) post-omicron are unknown. We compared severity and outcomes across SOT groups.
Methods: A single-center retrospective study of health system RVI in adult SOTR during 2022-2023 was conducted.
Results: Overall, 520 RVI episodes in 504 patients were included: 488 had 1 episode and 16 had 2 episodes. Lung, kidney, and heart transplant recipients comprised of 40.9%, 34.3%, and 20.8% of the cohort. There were 352 episodes of COVID-19 RVI and 148 ncRVI. All-cause and RVI-related hospitalization were comparable between COVID-19 and ncRVI (47.7% vs. 43.9%, p = 0.50; 32.1% vs. 31.1%, p = 0.91 respectively). Oxygen supplementation occurred in 11.9% of COVID-19 RVI and 11.5% of ncRVI with a maximum requirement (median, IQR) of 4.0 (2.0-18.8) and 2.0 (2.0-3.0) liters respectively (p = 0.005). Intensive care unit (ICU) admission occurred in 7.1% and 6.1%; non-invasive ventilation (NIV) in 2.3% and 4.1%; mechanical ventilation (I&V) in 4.0% and 2.0%; and inotropic/vasopressor support in 1.7% and 1.4%, for COVID-19 versus nCRVI, respectively. Patients with COVID-19 had ongoing symptoms in 16.8%, 10.2%, and 2.6% at 30 days, 3 month, and 12 month follow up respectively, compared with 16.9%, 4.7%, and 2.0% in ncRVI. Twelve-month mortality, rejection and graft dysfunction were similar between groups.
Conclusions: COVID-19 and ncRVI pose significant and comparable risk to SOTR in this post-omicron era, in hospitalization, oxygen requirement, and persistent symptoms. Treatment and prevention should be prioritized in this population.
Keywords: COVID‐19; respiratory viral infections; solid organ recipients.