학술논문
Excess mortality in COVID-19-affected solid organ transplant recipients across the pandemic
Document Type
Article
Author
Yamanaga, Shigeyoshi; Shimata, Keita; Ohfuji, Satoko; Yoshikawa, Mikiko; Natori, Yoichiro; Hibi, Taizo; Yuzawa, Kenji; Egawa, Hiroto; Unagami, Kohei; Ishida, Hideki; Omoto, Kazuya; Kasahara, Mureo; Uchida, Hajime; Sakamoto, Seisuke; Futamura, Kenta; Nishikawa, Kenta; Imamura, Ryoichi; Nakazawa, Shigeaki; Hatano, Etsuro; Ito, Takashi; Masano, Yuki; Nishihira, Morikuni; Hirata, Yuta; Sakuma, Yasunaru; Onishi, Yasuharu; Yokoyama, Naoki; Yamamoto, Shingo; Yamada, Yusuke; Ogura, Yasuhiro; Kurata, Nobuhiko; Uchida, Junji; Kabei, Kazuya; Iwamoto, Hitoshi; Ikeda, Chie; Shinoda, Kazunobu; Yoshiike, Miki; Hotta, Kiyohiko; Hidaka, Yuji; Iwami, Daiki; Ishii, Yasuo; Kamiyama, Manabu; Yoshizumi, Tomoharu; Kosai-Fujimoto, Yukiko; Kobayashi, Takaaki; Motoyama, Kentaro; Yamamoto, Megumi; Asai, Toshihiro; Tasaki, Masayuki; Kenmochi, Takashi; Ito, Taihei; Tokodai, Kazuaki; Fujio, Atsushi; Tsukamoto, Yasumasa; Watanabe, Takuya; Akamatsu, Nobuhisa; Yamashina, Sachi; Ishii, Daisuke; Kitajima, Kazuki; Yamada, Yasutoshi; Mitsuke, Akihiko; Sakaguchi, Takashi; Nakamura, Michio; Tomita, Yusuke; Nakamura, Yuki; Ishimoto, Tatsuro; Ohdan, Hideki; Tanimine, Naoki; Fujiwara, Takuzo; Yanagihara, Mitsuki; Hatakeyama, Shingo; Takai, Manabu; Nose, Kazuhiro; Kikuchi, Takashi; Mori, Yasunori; Araki, Motoo; Sekito, Takanori; Nishimura, Shingo; Tanabe, Tatsu; Igarashi, Yuto; Hidaka, Sumi; Watanabe, Masaaki; Ariyoshi, Yuichi; Hasegawa, Yasushi; Kamiyama, Masato; Yoneda, Tatsuo; Shimizu, Tomokazu; Nishikawa, Kouhei; Fukumoto, Takumi; Kuramitsu, Kaoru; Kato, Masashi; Saito, Mitsuru; Shinkai, Makoto; Usui, Hidehito; Sato, Masaaki; Eguchi, Hidetoshi; Imamura, Hiroki; Kobayashi, Shogo; Soejima, Yuji; Mita, Atsuyoshi; Kobayashi, Takashi; Nakamura, Kenji; Ohtsuka, Masayuki; Nakada, Shinichiro; Yagi, Takahito; Yasui, Kazuya; Matsuno, Naoto; Mizuno, Chiharu; Sugimoto, Mikio; Ueda, Nobufumi; Okada, Yoshinori; Hirama, Takashi; Toyooka, Shinichi; Sugimoto, Seichiro; Matsubara, Kei; Ikegami, Toru; Furukawa, Kenei; Nitta, Hiroyuki; Katagiri, Hirokatsu; Onita, Toru; Shiraishi, Takeshi; Mizuno, Shugo; Amiya, Eisuke; Shintani, Yasushi; Kanou, Takashi; Funaki, Soichiro; Miura, Yoshifumi; Nakajima, Daisuke; Urahashi, Taizen; Matsumiya, Goro; Watanabe, Michiko; Ebisu, Yosuke; Osawa, Ryosuke; Ono, Minoru; Sogawa, Hiroshi; Gomi, Harumi; Chen-Yoshikawa, Toyofumi; Yoshida, Kazunari; Ogawa, Naoko
Source
American journal of transplantation; 20240101, Issue: Preprints
Subject
Language
ISSN
16006135; 16006143
Abstract
The excess mortality of COVID-19 solid organ transplant recipients (SOTRs) throughout the pandemic remains unclear. This prospective cohort study based on the Japanese nationwide registry included 1,632 SOTRs diagnosed with COVID-19 between February 1, 2020, and July 31, 2022, categorized based on dominant phases of variants of concern (VOC): Waves 1–3 (Beta), 4 (Alpha), 5 (Delta), 6 (Omicron BA.1/BA.2), and 7 (Omicron BA.5). Excess mortality of COVID-19-affected SOTRs was analyzed by calculating standardized mortality ratios (SMRs). Overall, 1,632 COVID-19-confirmed SOTRs included 1,170 kidney, 408 liver, 25 lung, 20 heart, 1 small-intestine, and 8 multiorgan recipients. Although disease severity and all-cause mortality decreased as VOC transitioned, SMRs of SOTRs were consistently higher than those of the general population throughout the pandemic, showing a U-shaped gap that peaked toward the Omicron BA.5 phase; SMR (95% CI): 6.2 (3.1–12.5), 4.0 (1.5–10.6), 3.0 (1.3–6.7), 8.8 (5.3–14.5), and 21.9 (5.5–87.6) for Waves 1–3 (Beta), Wave 4 (Alpha), Wave 5 (Delta), Wave 6 (Omicron BA.1/2), and Wave 7 (Omicron BA.5), respectively. In conclusion, COVID-19 SOTRs had greater SMRs than the general population across the pandemic. Vaccine boosters, immunosuppression optimization, and other protective measures, particularly for older SOTRs, are paramount.