AbstractClinical phenotypes of COVID-19, associated with mortality risk, have been identified in the general population. The present study assesses their applicability in solid organ transplant recipients (SOTR) hospital-admitted by COVID-19. In a cohort of 488 SOTR, nonvaccinated (n = 394) and vaccinated (n = 94) against SARS-CoV-2, we evaluated 16 demographic, clinical, analytical, and radiological variables to identify the clinical phenotypes A, B, and C.

摘要在普通人群中已经发现了与死亡风险相关的新型冠状病毒肺炎的临床表型。本研究评估了它们在新型冠状病毒肺炎住院的实体器官移植受者（SOTR）医院的适用性。在488名SOTR，未接种疫苗（n=394）和接种疫苗（n=94）的SARS-CoV-2队列中，我们评估了16个人口统计学，临床，分析和放射学变量，以确定临床表型a，B和C。

The median age was 61.0 (51–69) years, 330 (67.6%) and 158 (32.4%) were men and women, respectively, 415 (85%) had pneumonia, and 161 (33%) had SpO2 < 95% at admission. All-cause mortality occurred in 105 (21.5%) cases. It was higher in nonvaccinated versus vaccinated SOTR (23.4% vs 13.8%, P = 0.04).

中位年龄为61.0（51-69）岁，男性和女性分别为330（67.6%）和158（32.4%），415（85%）患有肺炎，161（33%）入院时SpO2<95%。全因死亡105例（21.5%）。未接种疫苗的SOTR与接种疫苗的SOTR相比更高（23.4%比13.8%，P=0.04）。

Patients in the entire cohort were classified into phenotypes A (n = 149, 30.5%), B (n = 187, 38.3%), and C (n = 152, 31.1%), with mortality rates of 8.7%, 16.6%, and 40.1%, respectively, which were similar to those of nonvaccinated SOTR (9.5%, 16.7%, and 52.0%) and lower in vaccinated SOTR (4.4%, 15.8%, and 17.3%, respectively), with difference between nonvaccinated and vaccinated in the phenotype C (P < 0.001).

Patients in the entire cohort were classified into phenotypes A (n = 149, 30.5%), B (n = 187, 38.3%), and C (n = 152, 31.1%），死亡率分别为8.7%，16.6%和40.1%，与未接种SOTR（9.5%，16.7%和52.0%）相似，接种SOTR的死亡率较低（分别为4.4%，15.8%和17.3%），未接种和接种的表型C差异（P<0.001）。

In conclusion, COVID-19 clinical phenotypes are useful in SOTR, and all-cause mortality decreases in vaccinated patients..

总之，COVID-19临床表型在SOTR中是有用的，并且接种疫苗的患者的全因死亡率降低。。

IntroductionThe coronavirus disease (COVID-19) pandemic has led to significant morbidity and mortality, leading to the global collapse of the healthcare system. As of May 12, 2024, there were 775,481,326 confirmed cases and 7,049,376 deaths worldwide1. Throughout this global health crisis, a broad spectrum of disease severity has been observed in affected individuals.

引言冠状病毒病（COVID-19）大流行已导致严重的发病率和死亡率，导致全球医疗体系崩溃。截至2024年5月12日，全球共有775481326例确诊病例和7049376例死亡1。在这场全球健康危机中，在受影响的个体中观察到了广泛的疾病严重程度。

Understanding the heterogeneity of clinical presentation and underlying pathogenic mechanisms is crucial for optimizing patient management and resource allocation. Extensive epidemiological, clinical, and therapeutic studies have contributed to our understanding of pathogens and diseases. This wealth of information includes insights into the risk factors for unfavorable outcomes in the general population, focusing primarily on demographics, comorbidities, symptom severity, and laboratory findings2,3,4.

了解临床表现的异质性和潜在的致病机制对于优化患者管理和资源分配至关重要。广泛的流行病学，临床和治疗研究有助于我们对病原体和疾病的理解。这些丰富的信息包括对普通人群不良结局风险因素的深入了解，主要关注人口统计学，合并症，症状严重程度和实验室发现2,3,4。

In addition, factors related to immunology, virology5,6,7,8, and treatment9 have been explored.The global number of vaccinated individuals has been steadily increasing, with 13.5 billion vaccine doses administered as of November 26, 2023. In Western countries, particularly Andalusia and southern Spain, a remarkably high percentage of people have completed vaccination, reaching 100% in those over 60 years of age and 90% in the 40–60 age group10.

此外，还探讨了与免疫学，病毒学5,6,7,8和治疗9相关的因素。全球接种疫苗的人数一直在稳步增加，截至2023年11月26日，共接种了135亿剂疫苗。在西方国家，特别是安达卢西亚和西班牙南部，完成疫苗接种的人比例非常高，60岁以上的人达到100%，40-60岁年龄组达到90%。

Within the vaccinated population, COVID-19 predominantly affects vulnerable individuals, including those with either pluripathology or frailty, or both, and those with compromised immune responses. Furthermore, individuals receiving solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT) are at an elevated risk of developing severe forms of COVID-19, as seroconversion after immunization remains low11,12.

在接种疫苗的人群中，新型冠状病毒主要影响易感人群，包括多病理学或虚弱或两者兼有的人群，以及免疫反应受损的人群。此外，接受实体器官移植（SOT）或造血干细胞移植（HSCT）的个体发生严重形式的新型冠状病毒肺炎的风险较高，因为免疫后的血清转化率仍然很低11,12。

Therefore, understanding the factors.

因此，了解这些因素。

Data availability

数据可用性

All relevant data are within the paper and its Supporting information files. The raw data are accessible upon reasonable request to the corresponding author.

所有相关数据都在论文及其支持信息文件中。。

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EC, JSC and JR-B received grants from the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Proyectos de Investigación sobre el SARS-CoV-2 y la enfermedad COVID-19 (COV20/00370, COV20/00580, COV20/01031). EC and JSC also were supported by the grant IM22/INF/13 from the CIBERINFEC, Instituto de Salud Carlos III, Spain.

EC、JSC和JR-B获得了科学和创新部卡洛斯三世健康研究所的赠款，用于SARS-CoV-2和新型冠状病毒疾病（CoV20/00370、CoV20/00580、CoV20/01031）的研究项目。EC和JSC也得到了西班牙卡洛斯三世健康研究所网络感染IM22/INF/13号赠款的支持。

This study was also supported by CIBERINFEC - Consorcio Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU (EC and JS-C [CB21/13/00006], BG-G and JR-B (CB21/13/00012). JSC is a researcher belonging to the program “Nicolás Monardes” (RC-0002–2022), Servicio Andaluz de Salud, Junta de Andalucía, Spain.

这项研究还得到了CiberInfect-网络生物医学研究中心联盟、卡洛斯三世健康研究所、科学和创新部以及欧盟-下一代EU（EC和JS-C[CB21/13/0006]、BG-G和JR-B（CB21/13/00012）的支持。JSC是西班牙安达卢西亚委员会安达卢西亚卫生局“尼古拉斯·莫纳德斯”（RC-0002-2022）计划的研究员。

The ORCHESTRA project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 101016167.Author informationAuthor notesCarmen Infante-Domínguez and Sonsoles Salto-Alejandre contributed equally to this work.Authors and Affi.

根据第101016167号赠款协议，乐团项目已获得欧盟地平线2020研究与创新计划的资助。作者信息作者Notescarman Infante Domínguez和Sonsoles Salto Alejandre对这项工作做出了同样的贡献。作者和Affi。

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PubMed Google ScholarConsortiaThe COVIDSOT, ORCHESTRA Working TeamsCarmen Infante-Domínguez, Sonsoles Salto-Alejandre, Rocío Álvarez-Marín, Silvia Jiménez-Jorge, Javier Sánchez-Céspedes, Jerónimo Pachón, Elisa Cordero, José Miguel Cisneros, Manuela Aguilar-Guisado, José María Álamo-Martínez, Carmen Bernal-Bellido, Gabriel Bernal-Blanco, Pedro Camacho, Marta Carretero, Carmen Cepeda-Franco, Miguel Ángel Gómez-Bravo, Antonio Grande-Trillo, Luis Miguel Marín-Gómez, Laura Merino, Gema Montilla-Cosano, María Paniagua, José Manuel Sobrino-Márquez, Diego Rangel-Sousa, Blanca Villacorta-Linaza, Nuria Sabé, José Gonzàlez-Costello, Laura Lladó, Eduardo Melilli, Antonio Ramos-Martínez, Jorge Calderón-Parra, Ana Arias-Milla, Asunción Moreno, Marta Bodro, Laura Linares, Sabina Herrera, María Angeles Marcos, Federico Cofán, María Angeles Castel, Jordi Colmenero, Kamilla Ferreira de Moraes, Luis Fernando Aranha Camargo, Zaira R.

PubMed Google ScholarConsortiate Covidsot，管弦乐队工作团队Mscarmen Infante-Dominguez，Sonsoles Salto-Alejander，RocíoÁlvarez-Marín，Silvia Jimenez-Jorge，Javier Sanchez-Cespedes，Jeronimo Pachon，Elisa Cordero，JoséMiguel Cisneros，Manuela Aguilar-Guisado，Jos MaríaÁlamo-Martinez，Carmen Bernal-Bellido，Gabriel Bernal-Blanco，Pedro Camacho，Marta Carretero，Carmen Cepeda-Franco，Miguel Angel Gomez-Bravo我想，路易斯·米格尔·马林-戈麦斯、劳拉·梅里诺、杰玛·蒙蒂利亚-科萨诺、玛丽亚·帕尼阿瓜、何塞·曼努埃尔·索贝诺-马奎兹、迭戈·兰格尔-索萨、布兰卡·维拉科尔塔-利纳扎、努里亚·萨贝、何塞·冈萨雷斯-科斯特洛、劳拉·拉多、爱德华多·梅利利、安东尼奥·拉莫斯-马丁内斯、豪尔赫·卡尔德龙-帕拉、安娜·阿里亚斯-米拉、亚松森·莫雷诺、玛尔塔·博德罗、劳拉·利纳雷斯、萨比娜·埃雷拉、玛丽亚·安吉内斯马科斯、费德里科·科，路易斯·费尔南多·阿兰哈·卡马戈，扎伊尔。

Palacios-Baena, Belén Gutiérrez-Gutiérrez, Jesús Rodríguez-Baño, Belén Gallego, Natalia Maldonado-Lizarazo, Patricia Muñoz, Maricela Valerio, Ainhoa Fernández-Yunquera, Carlos Ortiz-Bautista, María Luisa Rodríguez-Ferrero, Mario Fernández-Ruiz, José María Aguado, Francisco López-Medrano, Rafael San Juan, Marino Blanes-Julia, Rosa Blanes-Hernández, Carmen Fariñas, Francisco Arnaiz de las Revillas-Almajano, Ignacio Fortea Ormaechea, Claudia González-Rico, Mónica Gozalo-Margüello, Aritz Gil-Ongay, Milagros Heras Vicario, Elisa Vidal, Julián de la Torre-Giménez, Julián de la Torre-Cisneros, Esperanza Merino de Lucas, Pilar González-de-la-Aleja, Silvia Otero, Héctor Pinargote-Celorio, Márcia Halpern, Elizabeth Balbi, Román Hernández-Gallego, Elena García de Vinuesa-Calvo, Rocío Martínez Gallardo, Matteo Bassetti, Laura Nicolini, Antonio Vena.

Palacios-Baena、Belén Gutiérrez-Gutiérrez、Jesús Rodríguez-Bath、伯利恒Gallego、Natalia Maldonado-Lizarazo、Patricia Muñoz、Maricela Valerio、Ainhoa Fernández-Yunquera、Carlos Ortiz-Bautista、Maria Luisa Rodríguez-Ferrero、Mario Fernández-Ruiz、Jos Maria Aguado、Francisco López-Medrano、Rafael San Juan、Marino Blanes-Julia、Rosa Blanes-Hernandez克劳迪娅·冈萨雷斯·里科，莫妮卡·戈扎洛-玛格丽特、阿里茨·吉尔·翁盖、米拉格罗斯·赫拉斯·维卡里奥、Elisa Vidal、朱利安·德拉托雷-吉梅内斯、朱利安·德拉托雷-西斯内罗斯、埃斯佩兰萨·梅里诺·德·卢卡斯、皮拉尔·冈萨雷斯-德拉亚历亚、西尔维娅·奥特罗、赫克托·皮纳戈特-塞洛里奥、玛丽亚·哈尔彭、伊丽莎白·巴尔比、罗曼·埃尔南德斯-加利西亚、埃琳娜·加西亚·德·维努埃萨-卡尔沃、罗西奥·马丁内斯加拉多、马泰奥·巴塞蒂、劳拉·。

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Reprints and permissionsAbout this articleCite this articleInfante-Domínguez, C., Salto-Alejandre, S., Álvarez-Marín, R. et al. COVID-19 clinical phenotypes in vaccinated and nonvaccinated solid organ transplant recipients: a multicenter validation study.

转载和许可本文引用这篇文章Infante Domínguez，C.，Salto Alejandre，S.，Álvarez-Marín，R。等人。接种疫苗和未接种疫苗的实体器官移植受者的COVID-19临床表型：多中心验证研究。

Sci Rep 14, 30021 (2024). https://doi.org/10.1038/s41598-024-81099-2Download citationReceived: 04 June 2024Accepted: 25 November 2024Published: 03 December 2024DOI: https://doi.org/10.1038/s41598-024-81099-2Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsSolid organ transplant recipientsCOVID-19Clinical phenotypesMortalityMulticenter cohort study

关键词固体器官移植受者VID-19临床表型死亡率多中心队列研究