Evolving Impact of COVID-19 on Intestinal Transplant Recipients: A Single-Center Experience

Background: There has been significant concern about coronavirus disease 2019 (COVID-19) among transplant recipients, particularly those who are highly immunosuppressed. Several studies have analyzed the impact of COVID-19 on different solid organ transplant patients. However, few isolated case reports of COVID-19 in intestinal and multivisceral transplant (ITx and MVTx) recipients are available in the literature. We report the first single-center study evaluating the clinical course and outcome of COVID-19 in ITx/MVTx recipients.

Methods: Adult patients (age ≥ 18 years) with confirmed cases of COVID-19 between February 2020 and February 2024 were included in this study.

Results: Twelve of the 67 (17.9%) ITx/MVTx recipients followed at our center had COVID-19. Seven patients (58%) were female, and the median age at diagnosis was 47 years (range: 31-68 years). The average time from transplantation to COVID-19 was 89 months (range: 14-215 months). Nine patients (75%) required hospitalization; three of them were admitted to the intensive care unit (ICU) and required ventilator support. One patient had COVID-19 on two different occasions. Treatment modalities consisted of monoclonal antibody treatment (n = 5), of antiviral therapy (n = 4), and steroid monotherapy (n = 1). Three patients received combination therapy. Three patients (25%) developed irreversible respiratory failure and died after prolonged ventilator use.

Conclusions: Our data suggested a possible increase in the incidence of COVID-19 in ITx and MVTx recipients with an unchanged mortality rate despite the use of vaccines and new therapeutic modalities. Further multicenter studies are needed to analyze the real impact of COVID-19 on this unique population.