Racial disparities in death due to COVID-19 persist among lung transplant recipients in US

Racial disparities in COVID-19 mortality persist in the U.S. among lung transplant recipients, according to data presented at the International Society for Heart and Lung Transplantation Annual Meeting and Scientific Sessions.

“Our group was interested in trying to look at disparities and come up with ways of not only identifying but finding ways to intervene to decrease the disparities observed within the cardiac surgery population, which lung transplant recipients fall into,” Stanley B. Wolfe, MD, cardiac research fellow in surgery at the Corrigan Minehan Heart Center at Massachusetts General Hospital, told Healio. “We know that the transplant population, whether it be lung, heart, kidney, etc., have very close follow-up compared to a standard patient, but they also are immunosuppressed, which increases your overall risk of getting severe COVID-19, as well as dying from COVID-19.”

Researchers utilized the Organ Procurement and Transplantation database to identify 17,198 adult lung transplant recipients in the U.S. Recipients were stratified by race: white (n = 13,755), Black (n = 1,598), Hispanic (n = 1,353) or other (n = 492).

The primary outcome was COVID-19 mortality. Secondary outcomes included all-cause mortality and non-COVID-19 mortality.

Overall, 1.34% of patients died of COVID-19.

COVID-19 mortality rates differed significantly by race (P = .001), the researchers reported. Rates were lowest among white lung transplant recipients (1.18%) and highest among Hispanic recipients (2.22%). Hispanic recipients had the lowest rates of non-COVID-19 mortality, while the highest rates were among Black recipients (9.53% vs. 14.77%; P = .008). Hispanic recipients had higher COVID-19 mortality rates compared with white recipients (P = .005) after adjustment. The researchers reported no difference in mortality rates among Black recipients compared with white participants (P = .066).

Researchers observed no difference in all-cause mortality (P = .054).

“Lung transplant recipients are not an exclusion from the disparities [in COVID-19] that we’ve seen across the United States,” Wolfe said.

Research on this topic will continue, according to the researchers.

“The next steps are to find better ways of identifying the sources of these inequities, whether it be a more granular look at the social determinants of health — such as economic status, access to health care — which we thought would be part of the reason we wanted to do this study because we know that all patients have access to health care,” Wolfe said. “The next steps are identifying the sources of these, and then the following step would be to try to find interventions that we can employ to combat these inequities observed.”

For more information:

Stanley B. Wolfe, MD, can be reached at swolfe3@mgh.harvard.edu.