Healthcare resource use among solid organ transplant recipients hospitalized with COVID‐19

Knowledge of hospital length of stay (LOS), intensive care unit (ICU) LOS, and duration of mechanical ventilation (MV) is essential for transplant centers to make informed decisions on resource allocation during surges in COVID‐19. Several studies have described these measures but are limited by sma...

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Published in:Clinical Transplantation 2021-02, Vol.35 (2), p.e14174-n/a
Main Authors: Heldman, Madeleine R., Kates, Olivia S., Haydel, Brandy M, Florman, Sander S., Rana, Meenakshi M., Chaudhry, Zohra S., Ramesh, Mayur S., Safa, Kassem, Kotton, Camille N., Blumberg, Emily A., Besharatian, Behdad D., Tanna, Sajal D., Ison, Michael G., Malinis, Maricar, Azar, Marwan M., Rakita, Robert M., Morillas, Jose A., Majeed, Aneela, Sait, Afrah S., Spaggiari, Mario, Hemmige, Vagish, Mehta, Sapna A., Neumann, Henry, Badami, Abbasali, Jeng, Amy, Goldman, Jason D., Lala, Anuradha, Hemmersbach‐Miller, Marion, McCort, Margaret E., Bajrovic, Valida, Ortiz‐Bautista, Carlos, Friedman‐Moraco, Rachel, Sehgal, Sameep, Lease, Erika D., Limaye, Ajit P., Fisher, Cynthia E.
Format: Article
Language:English
Subjects:
COVID-19 - epidemiology
COVID-19 - therapy
Health Resources - statistics & numerical data
Humans
Inpatients
Letter to the Editor
Letters to the Editor
Organ Transplantation
Pandemics
Transplant Recipients
United States - epidemiology
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Summary:Knowledge of hospital length of stay (LOS), intensive care unit (ICU) LOS, and duration of mechanical ventilation (MV) is essential for transplant centers to make informed decisions on resource allocation during surges in COVID‐19. Several studies have described these measures but are limited by small sample size, short or variable durations of follow‐up, or single‐center experiences.2-4 A recent multicenter study by Coll et al reports on hospital LOS in SOTR with COVID‐19, but follow‐up time was not standardized and neither MV duration nor ICU LOS was measured.4 To address these limitations, we performed analyses from data in a prospective, multicenter registry of 376 SOTR hospitalized with COVID‐19 with standardized 28‐day follow‐up, which has been previously described.1 Table 1 shows median hospital and ICU LOS, and duration of MV, stratified by transplanted organ and vital status at follow‐up. Newly admitted, n (%) 24 255 47 47 376 Non‐survivors 7 (29.2) 50 (19.7) 12 (25.5) 8 (17.0) 77 (20.5) Survivorsf f Survivors refer to patients alive on day 28 after COVID‐19 diagnosis. 17 (70.8) 205 (80.4) 35 (74.5) 39 (83.0) 299 (79.5) Median age (IQR), years 63.5 (54.3–68) 58 (46–66) 63 (55.5–68) 56 (48–71.5) 59 (47–67) ICU, n (%)g g For survivor and non‐survivor groups, percentages refer to percent of all survivors or all non‐survivors for each organ, respectively. 11 (45.8) 99 (38.8) 19 (40.4) 16 (34.0) 147 (39.1) Non‐survivors 6 (85.7) 40 (80.0) 7 (58.3) 5 (62.5) 58 (79.5) Survivors 5 (29.4) 59 (28.9) 12 (34.3) 11 (28.2) 89 (29.8) Mechanical ventilation, n (%)g g For survivor and non‐survivor groups, percentages refer to percent of all survivors or all non‐survivors for each organ, respectively. 9 (37.5) 81 (31.9) 16 (34.0) 10 (21.3) 117 (31.1) Non‐survivors 5 (71.4) 37 (74.0) 9 (75.0) 3 (37.5) 54 (75.0) Survivors 4 (23.5) 44 (21.6) 7 (20.0) 7 (18.0) 63 (21.1) Median hospital LOS, days (IQR) 9 (4–16.5) 9 (5–18) 13.5 (6–20) 10.5 (5–19) 10 (5–19) Non‐survivorsh h Excludes 1 kidney and 1 liver recipient for whom data were unavailable. 9 (6–12) 12 (6–16) 16 (7–19) 16 (6.3–23) 12 (6–18) Survivorsi 9 (4–20.3) 9 (5–18.5) 13 (7–20) 10 (5–15) 10 (5–19) Median ICU LOS, days (IQR) 8.5 (7–12) 12 (5–20) 9 (5–15) 11 (3–26) 11 (5–19) Non‐survivorsj j Excludes 2 kidney recipients for whom data were unavailable. 9 (8.3–11.3) 11 (5–14) 7 (5.5–12) 5 (5–19) 9 (5–14.5) Survivorsk k Excludes 1 lung, 8 kidney, and 1 heart recipient for whom data were unavailable. 7 (5.5–8.8) 14 (7–
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.14174