468. Delayed Mortality Among Solid Organ Transplant Recipients Hospitalized for Covid-19: An International Multicenter Study

Abstract Background Studies of solid organ transplant recipients (SOTr) hospitalized for Covid-19 have focused on short-term outcomes with approximately 30 days follow-up time. Intermediate-term mortality and associated risk factors intermediate-term death not previously been reported. Methods Using data from a multi-center registry, we assessed by 90 among SOTr between 3/1/2020 12/31/2020. Multivariable Cox-proportional hazard models were used to compare 28 days. Covariates selected priori based known predictors in Covid-19. All patients followed or censored at the time last clinical contact, if this occurred prior day after diagnosis. Results Among Covid-19, 198/979 (20%) died within diagnosis 37/198 (19%) deaths 29 90. Risk included age >65 years (1.8, 95% CI 1.3-2.4, P< 0.001), lung (compared non-lung) (1.6, 1.1-2.4, P=0.02), chronic disease (2.2, 1.5-3.4, P=0.002) heart failure (1.9, 1.2-2.9), which similar reported 28-day (Table 1). Diagnosis during second half 2020 (6/20-12/31/20) was lower (aHR 0.7, 0.5-1.0, P=0.03) compared early (3/1-6/19/20); however, late periods 0.9, 0.7-1.2, P=0.54). Obesity mTOR inhibitor use also but Kaplan-Meier survival curves period are shown Figure 1. Table Cox-Proportional Hazard Model Mortality 90-days Solid Organ Transplant Recipients Hospitalized (N=979) Survival SOT Vertical tick marks represent cases. Early refers cases diagnosed March 1 June 19, 20 December 31, 2020. Conclusion Approximately 20% Future investigations required discern mechanism(s) improvement early, late, course pandemic. Disclosures Madeleine R. Heldman, MD, Cigna Lifesource (Other Financial Material Support, Speaking honoraria)Thermo Fisher Scientific honoraria) Olivia S. Kates, Merk (Scientific Research Study Investigator) Ajit P. Limaye, astellas Investigator)CTI Investigator)GSK (Consultant)Johnson&Johnson Adjudication Committee)merck (Consultant, Grant/Research Investigator)moderna Investigator)Novartis DMC member)Novo Nordisk (Consultant)