{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:30:40Z","timestamp":1786681840151,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n While vaccination is a key strategy to mitigate the severity of coronavirus disease 2019 (COVID\u201019) in children, the risk factors for symptomatic, medically attended (hereon referred to as \u201csymptomatic\u201d) COVID\u201019 and the impact of vaccination are not well defined among pediatric solid organ transplant recipients (PSOTR).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n PSOTR aged six months through 21 years at 11 centers in the Pediatric Infectious Diseases Transplant Network (PIDTRAN) were analyzed retrospectively for symptomatic COVID\u201019 between July 2021 and May 2023. Using a Cox proportional hazards model, risk factors associated with COVID\u201019\u2010associated hospitalization, in\u2010hospital oxygen use, mechanical ventilation, and the impact of COVID\u201019 vaccination were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1370 PSOTR, 410 (29%) had symptomatic COVID\u201019 infection. Among those with symptomatic infection, 115 (28%) were hospitalized, 35 required in\u2010hospital oxygen, and three required mechanical ventilation. In the study, 45% were unvaccinated against COVID\u201019. Compared to unvaccinated PSOTR, incompletely vaccinated PSOTR had 56% lower hazard (95% CI 0.26, 0.72,\n p<\/jats:italic>\n = 0.001) of COVID\u201019\u2010associated hospitalization whereas completely vaccinated did not have a statistically significant difference in hazard of hospitalization. Receipt of at least one dose of the bivalent vaccine was also associated with 92.5% lower hazard (95% CI 0.010, 0.55,\n p<\/jats:italic>\n = 0.011) of hospitalization. Risk factors for hospitalization included chronic kidney disease, underlying heart disease, neurodevelopmental delay, and lymphocytopenia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Most PSOTR with symptomatic COVID\u201019 did not require hospitalization or respiratory support. Several comorbidities and lymphocytopenia are associated with severe COVID\u201019 in PSOTR. COVID\u201019 vaccination, mostly, protected PSOTR against COVID\u201019\u2010associated hospitalization, but vaccine uptake among PSOTR was low.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.70303","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:22:02Z","timestamp":1786681322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Coronavirus Disease 2019 Hospitalization and Vaccination Impact Among Pediatric Solid Organ Transplant Recipients in the United States"],"prefix":"10.1111","author":[{"given":"Sanya J.","family":"Thomas","sequence":"first","affiliation":[{"name":"Host Defense Program Section of Infectious Diseases Nationwide Children's Hospital Columbus Ohio USA"},{"name":"Division of Infectious Diseases Department of Pediatrics Ohio State University College of Medicine Columbus Ohio USA"},{"name":"Pediatric Infectious Diseases Columbia University Irving Medical Center and New York\u2010Presbyterian \u2013 Morgan Stanley Children's Hospital New York USA"},{"name":"Division of Infectious Diseases Department of Pediatrics Columbia University \u2013 Vagelos College of Physicians and Surgeons New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia E. Castillo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Infectious Diseases University of Nebraska Medical Center Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bocchini","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Brammer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Infectious Diseases Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Brock","sequence":"additional","affiliation":[{"name":"Center For Biostatistics Department of Biomedical Informatics The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Calimaran","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Dallas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases St. Jude Children's Research Hospital Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Downes","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine of the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Ferrolino","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases St. Jude Children's Research Hospital Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Rejuan","family":"Haque","sequence":"additional","affiliation":[{"name":"Center For Biostatistics Department of Biomedical Informatics The Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna R.","family":"Huppler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Medical College of Wisconsin and Children's Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishminder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Pediatrics David Geffen School of Medicine University of California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madan","family":"Kumar","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases Department of Pediatrics University of Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Landry","sequence":"additional","affiliation":[{"name":"Office of the Chair Department of Pediatrics University of Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacee","family":"Lerret","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Medical College of Wisconsin and Children's Wisconsin Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela M.","family":"Maron","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases St. Jude Children's Research Hospital Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Minniear","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases Department of Pediatrics University of Tennessee Health Science Center Memphis Tennessee USA"},{"name":"Le Bonheur Children's Hospital Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Muller","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Ann & Robert H. 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