Transplantation, HIV infection and immunosuppression: VCU Wright Center scientists contribute to studies using national COVID-19 data

Organ transplant recipients and people living with HIV are more likely to experience adverse effects after contracting COVID-19. And kidney and heart transplant recipients are at highest risk.

Those are just some of the conclusions coming from an international team of researchers that includes Virginia Commonwealth University data scientists. Amy Olex, M.S., and Evan French of the Wright Center for Clinical and Translational Research joined that team as co-authors on four recent publications that used data from the National COVID Cohort Collaborative (N3C).

N3C centralizes data on patients with COVID-19, allowing for meaningful study of the virus and its effects on patients. Olex, a senior bioinformatics specialist, and French, a research informatics systems analyst, are part of a group using that data to investigate the effects of COVID-19 on people who are immunocompromised or immunosuppressed.

“We knew that people with immunocompromising diseases were going to be vulnerable to COVID-19,” said Olex. “Our research is showing just how vulnerable – and why it’s important that public health initiatives strengthen efforts to address inequities.”

One study published in The Lancet HIV found that:

  • People with HIV are more likely to die from COVID-19, but had lower odds of contracting a mild to moderate case.
  • The elevated odds of death were higher among older age groups, male, Black, Hispanic and Latinx adults.

Research published in Transplantation Direct found that:

  • COVID-19-positive transplant patients were more likely to have had a kidney transplant and be non-white.
  • Comorbidities were common in all transplant patients but significantly more common in those who were COVID-19-positive.

Another study published in the American Journal of Transplantation found that:

  • There’s an increased risk of major adverse events for transplant recipients who contract COVID-19.
  • Kidney and heart transplant recipients were at highest risk.
  • Male transplant recipients with COVID-19 have an increased risk of adverse events compared with females, albeit to a lesser degree than in the general population.

A fourth study published in The Lancet Rheumatology found that:

  • People taking long-term immunosuppressive medications and admitted to the hospital with COVID-19 were actually at a reduced risk of requiring invasive mechanical ventilation.
  • There was no overall association between long-term immunosuppression and the risk of in-hospital death, except for patients with cancer or a rheumatologic condition taking the immunosuppressive drug Rituximab, for which there was an increased risk of in-hospital death.

A fifth paper is set to be published in JAMA Internal Medicine in late December. The study concerns people with immune dysfunction and their likelihood of contracting a breakthrough COVID-19 infection after vaccination.

VCU joined N3C last year as part of an effort to streamline COVID-19 patient data. The project, overseen and funded by the National Institutes of Health, will help researchers for years to come in the quest to understand the novel coronavirus.

“The more we know about COVID-19, the better we can prepare for the next pandemic — or maybe even prevent it,” Olex said. “N3C has been an invaluable resource for evaluating the data on a meaningful scale.”

The patient data is de-identified, meaning researchers do not see any identifying information about individual patients.

VCU researchers can access the national data with help from the Wright Center.

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Amy Olex, M.S., senior bioinformatics specialist, and Evan French, research informatics systems analyst

 

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