COVID-19 in solid organ transplant recipients: A systematic review and meta-analysis of current literature

Mohammed A. Raja, Maria A. Mendoza, Aasith Villavicencio, Shweta Anjan, John M. Reynolds, Veraprapas Kittipibul, Anmary Fernandez, Giselle Guerra, Jose F. Camargo, Jacques Simkins, Michele I. Morris, Lilian A. Abbo, Yoichiro Natori

Research output: Contribution to journalReview articlepeer-review

Abstract

Severe acute respiratory virus syndrome 2 (SARS-CoV-2) has led to a worldwide pandemic. Early studies in solid organ transplant (SOT) recipients suggested a wide variety of presentations, however, there remains a paucity of robust data in this population. We conducted a systematic review and meta-analysis of SOT recipients with SARS-CoV-2 infection from January 1st t October 9th, 2020. Pooled incidence of symptoms, treatments and outcomes were assessed. Two hundred and fifteen studies were included for systematic review and 60 for meta-analysis. We identified 2,772 unique SOT recipients including 1,500 kidney, 505 liver, 141 heart and 97 lung. Most common presenting symptoms were fever and cough in 70.2% and 63.8% respectively. Majority (81%) required hospital admission. Immunosuppressive medications, especially antimetabolites, were decreased in 76.2%. Hydroxychloroquine and interleukin six antagonists were administered in59.5% and 14.9% respectively, while only few patients received remdesivir and convalescent plasma. Intensive care unit admission was 29% from amongst hospitalized patients. Only few studies reported secondary infections. Overall mortality was 18.6%. Our analysis shows a high incidence of hospital admission in SOT recipients with SARS-CoV-2 infection. As management of SARS-CoV-2 continues to evolve, long-term outcomes among SOT recipients should be assessed in future studies.

Original languageEnglish (US)
Article number100588
JournalTransplantation Reviews
Volume35
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • COVID-19
  • Immunosuppression
  • Meta-analysis
  • SARS-CoV-2
  • Solid organ transplant
  • Systematic review

ASJC Scopus subject areas

  • Transplantation

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