Prognosis of patients after organ transplantation during active COVID-19 infection

Background: Solid organ transplant recipients represent one of the most clinically vulnerable populations in the ongoing COVID-19 pandemic. Chronic immunosuppression and multiple comorbidities significantly increase the risk of severe disease and death. Despite global advances in vaccination and therapy, practical tools for early risk assessment in this group remain limited. This study addresses a critical gap by identifying simple and universally available clinical markers that can be used at hospital admission to predict short-term outcomes in transplant recipients with COVID-19. Methods: We retrospectively analyzed a cohort of solid organ transplant recipients hospitalized with confirmed COVID-19 at the University Clinical Center in Gdańsk, Poland, between 2020 and 2022. Patients were admitted either to a general COVID-19 ward or to an intensive care unit based on disease severity. Data were collected from electronic medical records and included demographic characteristics, chest imaging, and routine laboratory tests: lymphocyte count, serum creatinine, aspartate aminotransferase, C-reactive protein, and procalcitonin. Statistical analyses were performed to evaluate the association of these variables with in-hospital mortality. Results: Our analysis identified that elevated levels of serum creatinine, aspartate aminotransferase, C-reactive protein, and procalcitonin were significantly associated with increased risk of in-hospital mortality. Conversely, a higher lymphocyte count at admission was associated with better survival. These markers are widely available, inexpensive, and can be assessed during the initial diagnostic workup. Conclusions: This study offers a practical, evidence-based approach to early risk stratification in transplant recipients with COVID-19. The identified laboratory markers are not only simple and accessible but also clinically meaningful, providing frontline clinicians with actionable information during the early stages of care. Given the ongoing threat of COVID-19 and the likelihood of future viral outbreaks, these findings have broad implications for managing immunosuppressed patients. The study contributes valuable insight to a currently underserved area of transplant medicine and has strong potential to inform clinical practice across diverse healthcare settings. Trial registration not applicable