TY - JOUR
T1 - COVID-19 in solid organ transplant recipients
T2 - A systematic review and meta-analysis of current literature
AU - Raja, Mohammed A.
AU - Mendoza, Maria A.
AU - Villavicencio, Aasith
AU - Anjan, Shweta
AU - Reynolds, John M.
AU - Kittipibul, Veraprapas
AU - Fernandez, Anmary
AU - Guerra, Giselle
AU - Camargo, Jose F.
AU - Simkins, Jacques
AU - Morris, Michele I.
AU - Abbo, Lilian A.
AU - Natori, Yoichiro
N1 - Funding Information:
The authors would like to thank Tara Brigham, MLIS, from the Mayo Clinic Libraries in Jacksonville, FL, for peer review of the Medline database search strategy.
Publisher Copyright:
© 2020
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
KW - COVID-19
KW - Immunosuppression
KW - Meta-analysis
KW - SARS-CoV-2
KW - Solid organ transplant
KW - Systematic review
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U2 - 10.1016/j.trre.2020.100588
DO - 10.1016/j.trre.2020.100588
M3 - Review article
C2 - 33246166
AN - SCOPUS:85096721311
VL - 35
JO - Transplantation Reviews
JF - Transplantation Reviews
SN - 0955-470X
IS - 1
M1 - 100588
ER -