2
IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare systems globally. The lack of quality guidelines on the management of COVID-19 in rheumatologic disease, renal disease, hematological malignancy, and solid organ transplant recipients has resulted in a wide variation in clinical practice.MethodsUsing a Delphi process, a panel of 16 key opinion leaders developed clinical practice statements regarding vaccine recommendations in areas where standards are absent or limited. Agreement among practicing physicians with consensus statements was also assessed via an online physician survey. The strength of the consensus was determined by the following rating system: a strong rating was defined as all four key opinion leaders (KOLs) rating the statement ≥ 8, a moderate rating was defined as three out of four KOLs rating the statement ≥ 8, and no consensus was defined as less than three out of four KOLs provided a rating of ≤ 8. Specialists voted on agreement with each consensus statement for their disease area using the same ten-point scoring system.ResultsKey opinion leaders in rheumatology, nephrology, and hematology achieved consensuses for all nine statements pertaining to the primary and booster series with transplant physicians reaching consensus on eight of nine statements. Experts agreed that COVID-19 vaccines are safe, effective, and well tolerated by patients with rheumatological conditions, renal disease, hematologic malignancy, and recipients of solid organ transplants. The Delphi process yielded strong to moderate suggestions for the use of COVID-19 messenger ribonucleic acid (mRNA) vaccines and the necessity of the COVID-19 booster for the immunocompromised population. The expert panel had mixed feelings concerning the measurement of antibody titers, higher-dose mRNA vaccines, and the development of disease-specific COVID-19 guidance.ConclusionsThese results confirmed the necessity of COVID-19 vaccines and boosters in immunocompromised patients with rheumatologic disease, renal disease, hematological malignancy, and solid organ transplant recipients. Statements where consensus was not achieved were due to absent or limited evidence.
21Observations on improving COVID-19 vaccination responses in kidney transplant recipients: heterologous vaccination and immunosuppression modulation
Observations on improving COVID-19 vaccination responses in kidney transplant recipients: heterologous vaccination and immunosuppression modulation
Read more5Efficacy of the COVID-19 vaccine in heart transplant recipients: what we know and what we ignore.
Efficacy of the COVID-19 vaccine in heart transplant recipients: what we know and what we ignore.
6COVID-19 Vaccination in Kidney Transplant Recipients: An Ounce Pre-Transplant is Worth a Pound Post-Transplant.
COVID-19 Vaccination in Kidney Transplant Recipients: An Ounce Pre-Transplant is Worth a Pound Post-Transplant.
66Prolonged SARS-CoV-2 shedding and mild course of COVID-19 in a patient after recent heart transplantation.
Prolonged SARS-CoV-2 shedding and mild course of COVID-19 in a patient after recent heart transplantation.
116De Novo and Relapsing Glomerular Diseases After COVID-19 Vaccination: What Do We Know So Far?
De Novo and Relapsing Glomerular Diseases After COVID-19 Vaccination: What Do We Know So Far?
13Multisystem inflammatory syndrome in children associated with SARS-CoV-2 in a solid organ transplant recipient.
Multisystem inflammatory syndrome in children associated with SARS-CoV-2 in a solid organ transplant recipient.
5Post-mortem molecular investigations of SARS-CoV-2 in an unexpected death of a recent kidney transplant recipient.
Post-mortem molecular investigations of SARS-CoV-2 in an unexpected death of a recent kidney transplant recipient.
34COVID-19 in Kidney Transplantation: Outcomes, Immunosuppression Management, and Operational Challenges.
COVID-19 in Kidney Transplantation: Outcomes, Immunosuppression Management, and Operational Challenges.
13Humoral Responses After SARS-CoV-2 mRNA Vaccination and Breakthrough Infection in Cancer Patients
Humoral Responses After SARS-CoV-2 mRNA Vaccination and Breakthrough Infection in Cancer Patients
3VCA in the Era of the COVID-19 Pandemic.
VCA in the Era of the COVID-19 Pandemic.
Mortality and Readmissions of Solid-Organs Transplant Recipients Hospitalized Due to COVID-19 Infection with the Omicron Variant: A Matched Cohort Study.
Solid organ transplant (SOT) recipients represent a particularly vulnerable group due to their reliance on immunosuppressive therapies. Previous studies indicated a mortality rate of 20%-30% among SOT recipients with coronavirus disease 2019 (COVID-19). With the advent of the Omicron variant in November 2021, characterized by milder symptoms and lower mortality rates in the general population, safety measures relaxed, potentially impacting vulnerable populations like SOT recipients. To investigate mortality and morbidity among hospitalized SOT recipients with COVID-19 infection during the Omicron wave. A retrospective, propensity-matched cohort study conducted at the Rabin Medical Center, Israel, spanned from November 2021 to June 2023. Adult SOT recipients hospitalized with COVID-19 were compared to matched controls. Among 139 hospitalized SOT recipients and 209 controls, SOT recipients hospitalized with COVID-19 displayed higher in-hospital mortality (19% vs. 11%) and 90-day all-cause mortality (30% vs. 17%). In addition, the 90-day readmission rate was significantly higher among SOT recipients (43% vs. 31%). Multivariable analysis confirmed these trends, with SOT recipients exhibiting increased risk for mortality, readmission, invasive ventilation, and intensive care unit admission. The heightened vulnerability of hospitalized SOT recipients during the Omicron wave was characterized by higher mortality and readmission rates compared to matched controls. Despite the perceived milder nature of the Omicron variant, SOT recipients remain disproportionately affected. Continued vigilance and targeted interventions are necessary for this population including vaccinations and adherence to preventive measures. Investigating this population's outcomes through the changing COVID-19 variants is still warranted.
Read more23COVID-19 and Solid Organ Transplantation: Role of Anti-SARS-CoV-2 Monoclonal Antibodies.
Purpose of ReviewSolid organ transplant recipients (SOTRs) are ideal candidates for early treatment or prevention of coronavirus disease 2019 (COVID-19) using anti-SARS-CoV-2 monoclonal antibodies because of multiple underlying medical conditions, chronic immune-suppression, sub-optimal immunogenic response to vaccination, and evolving epidemiological risks. In this article, we review pertinent challenges regarding the management of COVID-19 in SOTRs, describe the role of active and passive immunity in the treatment and prevention of COVID-19, and review real-world data regarding the use of anti-SARS-CoV-2 monoclonal antibodies in SOTRs.Recent FindingsThe use of an anti-SARS-CoV-2 monoclonal antibody in high-risk solid organ transplant recipients is associated with a reduction in the risk of hospitalization, need for intensive care, and death related to COVID-19. Overall, the early experiences from a diverse population of solid organ transplant recipients who were treated with anti-spike monoclonal antibodies are encouraging with no reported acute graft injury, severe adverse events, or deaths related to COVID-19.SummaryAnti-SARS-CoV-2 antibodies are currently authorized for treatment of mild-moderate COVID-19 and post-exposure prophylaxis, including in SOTRs. Potential future uses include pre-exposure prophylaxis in certain high-risk persons and synergistic use along with emerging oral treatment options. Successful timely administration of anti-SARS-CoV-2 monoclonal antibodies requires a multidisciplinary team approach, effective communication between patients and providers, awareness of circulating viral variants, acknowledgement of various biases affecting treatment, and close monitoring for efficacy and tolerability.
Read more46Excess mortality in solid organ transplant recipients hospitalized with COVID-19: A large-scale comparison of SOT recipients hospitalized with or without COVID-19.
BackgroundSolid‐organ transplant (SOT) recipients with coronavirus disease 2019 (COVID‐19) have higher risk of adverse outcomes compared to the general population. Whether hospitalized SOT recipients with COVID‐19 are at higher risk of mortality than SOT recipients hospitalized for other causes, including non‐COVID‐19 pneumonia, remains unclear.MethodsWe used logistic regression to compare outcomes of SOT recipients hospitalized with COVID‐19 to non‐COVID‐19 related admissions and with non‐COVID‐19 pneumonia.ResultsOf 17,012 hospitalized SOT recipients, 1682 had COVID‐19. Those with COVID‐19 had higher odds of ICU admission (adjusted odds ratio [aOR] 2.12 [95%CI: 1.88–2.39]) and mechanical ventilation (aOR 3.75 [95%CI: 3.24–4.33]). COVID‐19 was associated with higher odds of in‐hospital death, which was more pronounced earlier in the pandemic (aOR 9.74 [95%CI: 7.08–13.39] for April/May vs. aOR 7.08 [95%CI: 5.62–8.93] for June through November 2020; P‐interaction = .03). Compared to SOT recipients hospitalized with non‐COVID‐19 pneumonia, odds of in‐hospital death were higher in SOT recipients with COVID‐19 (aOR 2.44 [95% CI: 1.90–3.13]), regardless of time of hospitalization (P‐interaction > .40).ConclusionsIn this large cohort of SOT recipients, hospitalization with COVID‐19 was associated with higher odds of complications and in‐hospital mortality than non‐COVID‐19 related admissions, and 2.5‐fold higher odds of in‐hospital mortality, compared to SOT recipients with non‐COVID‐19 pneumonia.
Read more
2Coronavirus disease 2019 in solid organ transplant recipients in the setting of proactive screening and contact tracing of Qatar.
Background: Clinical data on Coronavirus Disease 2019 (COVID-19) in solid organ transplant (SOT) recipients are limited. We herein report the initial clinical experience with COVID-19 in SOT recipients in Qatar.Methods: All SOT recipients with laboratory-confirmed COVID-19 up to May 23, 2020 were included. Demographic and clinical data were extracted retrospectively from the hospital’s electronic health records. Categorical data are presented as frequency and percentages, while continuous variables are summarized as medians and ranges.Results: Twenty-four SOT recipients with COVID-19 were identified (kidney 16, liver 6, heart 1, and liver and kidney 1). Organ transplantation preceded COVID-19 by a median of 60 months (range 1.7–184). The median age was 57 years (range 24–72), and 9 (37.5%) transplant recipients were females. Five (21%) asymptomatic patients were diagnosed through proactive screening. For the rest, fever (15/19) and cough (13/19) were the most frequent presenting symptoms. Five (20.8%) patients required invasive mechanical ventilation in the intensive care unit (ICU). Eleven (46%) patients developed acute kidney injury, including three in association with drug-drug interactions involving investigational COVID-19 therapies. Maintenance immunosuppressive therapy was modified in 18 (75%) patients, but systemic corticosteroids were not discontinued in any. After a median follow-up of 226 days (26–272), 20 (83.3%) patients had been discharged home, 2 (8.3%) were still hospitalized, 1 (4.2%) was still in the ICU, and 1 (4.2%) had died.Conclusions: Our results suggest that asymptomatic COVID-19 is possible in SOT recipients and that overall outcomes are not uniformly worse than those in the general population. The results require confirmation in large, international cohorts.
Read more20COVID-19 vaccination in the setting of mastocytosis—Pfizer-BioNTech mRNA vaccine is safe and well tolerated
COVID-19 vaccination in the setting of mastocytosis—Pfizer-BioNTech mRNA vaccine is safe and well tolerated
Copyright 2026 Cactus Communications. All rights reserved.
