The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hospitalization and death, and the effects of SARS-CoV-2 vaccines in solid organ transplant recipients (SOTRs) is still debated. We performed a nationwide, population-based, matched cohort study, including all Danish SOTRs (n = 5184) and a matched cohort from the general population (n = 41 472). Cox regression analyses were used to calculate incidence rate ratios (IRRs). SOTRs had a slightly increased risk of SARS-CoV-2 infection and were vaccinated earlier than the general population. The overall risk of hospital contact with COVID-19, severe COVID-19, need for assisted respiration, and hospitalization followed by death was substantially higher in SOTRs (IRR: 32.8 95%CI [29.0–37.0], 9.2 [6.7–12.7], 12.5 [7.6–20.8], 12.4 [7.9–12.7]). The risk of hospitalization and death after SARS-CoV-2 infection decreased substantially in SOTRs after the emergence of the Omicron variant (IRR: 0.45 [0.37–0.56], 0.17 [0.09–0.30]). Three vaccinations reduced the risk of SARS-CoV-2 infection only marginally compared to two vaccinations, but SOTRs with three vaccinations had a lower risk of death (IRR: 022 [0.16–0.35]). We conclude that SOTRs have a risk of SARS-CoV-2 infection comparable to the general population, but substantially increased the risk of hospitalization and death following SARS-CoV-2 infection. A third vaccination only reduces the risk of SARS-CoV2 infection marginally, but SOTRs vaccinated 3 times have reduced mortality.

中文翻译：

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接受和未接受实体器官移植的个体感染 SARS-CoV-2 后的结果——一项丹麦全国队列研究

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染、住院和死亡的风险，以及 SARS-CoV-2 疫苗对实体器官移植受者 (SOTR) 的影响仍在争论中。我们进行了一项全国性的、基于人群的匹配队列研究，包括所有丹麦 SOTR ( n  = 5184) 和来自一般人群的匹配队列 ( n = 41 472）。Cox 回归分析用于计算发病率比 (IRR)。SOTR 感染 SARS-CoV-2 的风险略有增加，并且比一般人群更早接种疫苗。在 SOTR 中，医院接触 COVID-19、重症 COVID-19、需要辅助呼吸和住院后死亡的总体风险要高得多（IRR：32.8 95%CI [29.0–37.0]、9.2 [6.7–12.7] , 12.5 [7.6–20.8], 12.4 [7.9–12.7])。在出现 Omicron 变体后，SOTR 中 SARS-CoV-2 感染后住院和死亡的风险显着降低（IRR：0.45 [0.37-0.56]、0.17 [0.09-0.30]）。与两次接种疫苗相比，三次疫苗接种仅略微降低了 SARS-CoV-2 感染的风险，但接种三次疫苗的 SOTR 的死亡风险较低（IRR：022 [0.16-0.35]）。我们得出结论，SOTR 感染 SARS-CoV-2 的风险与普通人群相当，但大大增加了 SARS-CoV-2 感染后住院和死亡的风险。第三次疫苗接种仅略微降低了 SARS-CoV2 感染的风险，但接种 3 次疫苗的 SOTR 降低了死亡率。