COVID-19 mortality among solid organ transplant recipients and candidates before specific vaccine availability in Colombia

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a life-threatening disease that was declared a pandemic in March 2020. Organ transplant recipients are vulnerable to infection and complications from COVID-19. The objective of this study was to investigate the rates of infection, mortality, and case-fatality ratios (CFR) in solid organ transplant recipients and patients on the waiting list for organ allocation in the period prior to the availability of specific vaccines.

Methodology: This was an observational study of official sources that are used to report information on COVID-19. Quantitative variables were described with arithmetic means and categorical variables with proportions. Percentages of positivity to infection, number of deaths, CFR, and all-cause mortality were calculated for each group and subgroup.

Results: There were 2,551 eligible subjects; 602 (26.2%) were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There were 265 (10.4%) deaths from all causes during the follow-up period; 119 (44.9%) of them were associated with COVID-19, which indicated a COVID-19-related mortality rate of 4.7 %. CFRs were 21.4% and 17.1% in transplant recipients and waitlisted patients, respectively. CFR was significantly higher in transplant recipients (23.8%) than in patients waitlisted for kidney (16.5%; p = 0.044) Among SARS-CoV-2-positive patients, the probability of dying from COVID-19 was higher in the first group (87.3% and 73%, respectively; p = 0.034).

Conclusions: COVID-19 had a significant impact on the deaths of transplant patients and patients on the solid organ waiting list during the first year of the pandemic in Colombia, before the availability of vaccines.