AIMS OF THE STUDY
The impact of coronavirus disease 2019 (COVID-19) on patients listed
for solid organ transplantation has not been systematically
investigated to date. Thus, we assessed occurrence and effects of
infections with severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) on patients on the Swiss national waiting list for
solid organ transplantation.
Patient data were retrospectively extracted from the Swiss Organ
Allocation System (SOAS). From 16 March to 31 May 2020, we included
all patients listed for solid organ transplantation on the Swiss
national waiting list who were tested positive for SARS-CoV-2.
Severity of COVID-19 was categorised as follows: stage I, mild
symptoms; stage II, moderate to severe symptoms; stage III, critical
symptoms; stage IV, death. We compared the incidence rate
(laboratory-confirmed cases of SARS-CoV-2), the hospital admission
rate (number of admissions of SARS-CoV-2-positive individuals), and
the case fatality rate (number of deaths of SARS-CoV-2-positive
individuals) in our study population with the general Swiss
population during the study period, calculating age-adjusted
standardised incidence ratios and standardised mortality ratios,
with 95% confidence intervals (CIs).
A total of 1439 patients were registered on the Swiss national solid
organ transplantation waiting list on 31 May 31 2020. Twenty-four
(1.7%) waiting list patients were reported to test positive for
SARS-CoV-2 in the study period. The median age was 56 years
(interquartile range 45.3–65.8), and 14 (58%) were male.
Of all patients tested positive for SARS-CoV-2, two patients were
asymptomatic, 14 (58%) presented in COVID-19 stage I, 3 (13%) in
stage II, and 5 (21%) in stage III. Eight patients (33%) were
admitted to hospital, four (17%) required intensive care, and three
(13%) mechanical ventilation. Twenty-two patients (92%) of all those
infected recovered, but two male patients aged >65 years with
multiple comorbidities died in hospital from respiratory failure.
Comparing our study population with the general Swiss population,
the age-adjusted standardised incidence ratio was 4.1 (95% CI
The overall rate of SARS-CoV-2 infections in candidates awaiting
solid organ transplantation was four times higher than in the Swiss
general population; however, the frequency of testing likely played
a role. Given the small sample size of affected patients,
conclusions have to be drawn cautiously and results need
verification in larger cohorts.
Benden C, Haile S, Kruegel N, Beyeler F, Aubert J D, Binet I,
Golshayan D, Hadaya K, Mueller T, Parvex P, Immer F. SARS-CoV-2 /
COVID-19 in patients on the Swiss national transplant waiting list.
Swiss Med Wkly 2020; 150:w20451.