Solid organ transplant recipients (SOTRs) have a heightened risk of adverse coronavirus disease 2019 (COVID-19) outcomes because of immunosuppression and medical comorbidity. We quantified the burden of COVID-19 mortality in United States (US) SOTRs. A sample of deaths documented in the US solid organ transplant registry from June 2020 through December 2022 was linked to the National Death Index to identify COVID-19 deaths and weighted to represent all SOTR deaths during the study period. Among 505 757 SOTRs, 57 575 deaths occurred, and based on the linkage, 12 396 (21.5%) were due to COVID-19. COVID-19 mortality was higher in males (mortality rate ratio [MRR]: 1.13), SOTRs aged 65 years and older (MRR: 1.50 in ages 65-74 vs ages 55-64 years), and non-Hispanic Black and Hispanic SOTRs (MRRs: 1.55 and 1.79 vs non-Hispanic White SOTRs). Kidney and lung recipients had the highest COVID-19 mortality, followed by heart, and then liver recipients. COVID-19 mortality also varied over time and across US states. Overall, SOTRs had a 7-fold increased risk of COVID-19 death compared to the US general population. SOTRs comprised 0.13% of the US population but accounted for 1.46% of all US COVID-19 deaths. SOTRs experience greatly elevated COVID-19 mortality. Clinicians should continue to prioritize COVID-19 prevention and treatment in this high-risk population.

中文翻译：

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美国实体器官移植受者 COVID-19 死亡负担


由于免疫抑制和医学合并症，实体器官移植受者 （SOTR） 发生 2019 冠状病毒病 （COVID-19） 不良结果的风险更高。我们量化了美国 （US） SOTR 的 COVID-19 死亡负担。从 2020 年 6 月到 2022 年 12 月，美国实体器官移植登记处记录的死亡样本与国家死亡指数相关联，以确定 COVID-19 死亡人数，并加权以代表研究期间的所有 SOTR 死亡人数。在 505 757 例 SOTR 中，发生了 57 575 例死亡，根据相关性，12 396 例 （21.5%） 是由于 COVID-19 造成的。COVID-19 死亡率在男性（死亡率比 [MRR]：1.13）、65 岁及以上的 SOTR（MRR：65-74 岁与 55-64 岁的 MRR：1.50）以及非西班牙裔黑人和西班牙裔 SOTR（MRR：1.55 和 1.79 对非西班牙裔白人 SOTR）中较高。肾脏和肺受者的 COVID-19 死亡率最高，其次是心脏，然后是肝脏受者。COVID-19 死亡率也随时间和美国各州而变化。总体而言，与美国普通人群相比，SOTR 的 COVID-19 死亡风险增加了 7 倍。SOTR 占美国人口的 0.13%，但占美国所有 COVID-19 死亡人数的 1.46%。SOTR 的 COVID-19 死亡率大大升高。临床医生应继续优先考虑这一高危人群的 COVID-19 预防和治疗。