SARS-CoV-2 infection in pediatric solid organ transplant recipients - a single center observation.

ABSTRACT:

Background

This is a descriptive study to characterize rates of SARS-CoV-2 infection in pediatric solid organ transplant (SOT) recipients during the early days of the pandemic. We hypothesized that asymptomatic infection may represent a large proportion of SARS-CoV-2 infection in ped SOT recipients.

Methods

We queried OTTR for all pediatric SOT recipients followed at our center and reviewed medical records to identify patients tested for SARS-CoV-2 between March 15, 2020 through June 30, 2021. Patients were tested by PCR: prior to planned procedures or because of symptoms; OR: tested by measurement of IgG to spike protein with their routine labs q 2-monthly. A positive PCR was called acute infection. A positive IgG with negative PCR was called convalescence. For immunologic studies, blood was obtained when the PCR or IgG was positive. Statistical comparisons were made between (i) acute infection vs. convalescence; (ii) acute infection vs. SOT recipients without infection (called healthy controls); (iii) LT vs. SB/MVT; (iii) positive vs. negative test result.

Results

Of 257 liver transplant (LT) recipients, 99 were tested: 6 were PCR positive,13 were antibody positive. Of 150 small bowel (SB)/ multi-visceral transplant (MVT) recipients, 55 were tested: 4 were PCR positive, 6 were antibody positive. Of 8 simultaneous liver, kidney transplant recipients, 3 were tested: 1 was PCR positive. Symptoms when present were mostly mild. Patients with a positive test result were younger (6.3 vs. 10.0-years; p=0.017). We observed a rapid decline in viral load within 96-hours without a change in immunosuppression. Antibody lasted >8-months beyond the time it was monitored. Acute infection was associated with increased CD4 and CD8 TEM cell frequency (p=0.04, p=0.03 respectively), decreased IFN-γ production from T-cells (2.8% vs.11.3% p=0.006), and decreased CD8 TEMRA frequency (4.56% vs.11.70% p=0.006).

Conclusion

Early in the pandemic, COVID-19 disease was mostly mild in pediatric SOT recipients with no rejection, patient death, or graft loss observed.

SUBMITTER: Paul S 

PROVIDER: S-EPMC9365074 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature