Epidemiology and Clinical Impact of Confirmed Respiratory Viral Infections in Solid Organ Transplant Recipients
Prins, Manon LM van Dokkum, Ernst D de Vries, Aiko PJ Tushuizen, Maarten E van der Helm, Danny Spithoven, Edwin M van der Meer, Irene M Scholten, Eduard M Vollaard, Albert M le Cessie, Saskia
Prins, Manon LM
van Dokkum, Ernst D
de Vries, Aiko PJ
Tushuizen, Maarten E
van der Helm, Danny
Spithoven, Edwin M
van der Meer, Irene M
Scholten, Eduard M
Vollaard, Albert M
le Cessie, Saskia
Series / Report no.
Open Access
Type
Journal Article
Multicenter Study
Article
Multicenter Study
Article
Language
en
Date of publication
2025-11-08
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Epidemiology and Clinical Impact of Confirmed Respiratory Viral Infections in Solid Organ Transplant Recipients
Translated Title
Published in
Transpl Infect Dis 2026; 28(1):e70128
Abstract
BACKGROUND: Respiratory viral infections (RVIs) can have distinct clinical presentations and outcomes in non-lung solid organ transplant (SOT) recipients compared to non-transplant and lung transplant patients. Understanding their impact is crucial for improving patient care and outcomes.
METHODS: This multicenter retrospective study analyzed adult non-lung SOT recipients with PCR-confirmed symptomatic RVIs from eight Dutch hospitals (January 2013-July 2024) to characterize clinical characteristics and outcomes of mono- and co-infections and identify risk factors for intensive care admission or 30-day mortality.
RESULTS: In total, 603 RVIs were identified in 460 recipients (kidney: 501; liver: 75; pancreas/islet of Langerhans: 4; combined: 23). The most common viruses were SARS-CoV-2 (36%), influenza A/B (29%), rhinovirus (14%), and RSV (7%). Influenza cases showed higher rates of fever (72%), common cold symptoms (37%), and myalgia (29%) than other viruses. Hospitalization occurred in 68% (384/565). Factors independently associated with intensive care admission or 30-day mortality included higher CURB-65 score (OR 1.91; 95% CI 1.36-2.70; p < 0.01), radiologic infiltrates (OR 3.04; 95% CI 1.60-5.80; p < 0.01), and SARS-CoV-2 infection (OR 1.67; 95% CI 1.05-2.67; p = 0.03). In contrast, influenza infection was associated with a lower risk (OR 0.21; 95% CI 0.07-0.62; p < 0.01). Co-infections were not linked to worse outcomes compared to mono-infections.
CONCLUSION: Overall, RVIs in non-lung SOT recipients were associated with high hospitalization and mortality rates. SARS-CoV-2 posed the highest risk for complications, while influenza was associated with a lower risk of severe outcomes. No association was found between co-infection and poor outcomes.