Risk of Severe COVID-19 and Protective Effectiveness of Vaccination Among Solid Organ Transplant Recipients
- Authors
- Huh, Kyungmin; Kang, Minsun; Kim, Young-Eun; Choi, Yoonkyung; An, Soo Jeong; Seong, Jaehyun; Go, Min Jin; Kang, Ji-Man; Jung, Jaehun
- Issue Date
- Apr-2024
- Publisher
- OXFORD UNIV PRESS INC
- Keywords
- COVID-19; organ transplantation; vaccines; big data
- Citation
- JOURNAL OF INFECTIOUS DISEASES, v.229, no.4, pp 1026 - 1034
- Pages
- 9
- Journal Title
- JOURNAL OF INFECTIOUS DISEASES
- Volume
- 229
- Number
- 4
- Start Page
- 1026
- End Page
- 1034
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/91114
- DOI
- 10.1093/infdis/jiad501
- ISSN
- 0022-1899
1537-6613
- Abstract
- Background Solid organ transplant recipients (SOTRs) are at higher risk for severe infection. However, the risk for severe COVID-19 and vaccine effectiveness among SOTRs remain unclear.Methods This retrospective study used a nationwide health care claims database and COVID-19 registry from the Republic of Korea (2020 to 2022). Adult SOTRs diagnosed with COVID-19 were matched with up to 4 non-SOTR COVID-19 patients by propensity score. Severe COVID-19 was defined as treatment with high-flow nasal cannulae, mechanical ventilation, or extracorporeal membrane oxygenation.Results Among 6783 SOTRs with COVID-19, severe COVID-19 was reported with the highest rate in lung transplant recipients (13.16%), followed by the heart (6.30%), kidney (3.90%), and liver (2.40%). SOTRs had a higher risk of severe COVID-19 compared to non-SOTRs, and lung transplant recipients showed the highest risk (adjusted odds ratio, 18.14; 95% confidence interval [CI], 8.53-38.58). Vaccine effectiveness against severe disease among SOTRs was 47% (95% CI, 18%-65%), 64% (95% CI, 49%-75%), and 64% (95% CI, 29%-81%) for 2, 3, and 4 doses, respectively.Conclusions SOTRs are at significantly higher risk for severe COVID-19 compared to non-SOTRs. Vaccination is effective in preventing the progression to severe COVID-19. Efforts should be made to improve vaccine uptake among SOTRs, while additional protective measures should be developed. In this nationwide claims-based study in Korea, the risk of severe COVID-19 was significantly higher in solid organ transplant recipients (SOTRs) compared to non-SOTRs. Vaccination showed significant effectiveness in reducing the risk of severe COVID-19 among SOTRs.
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