Systematic Review and Meta-analysis of COVID-19 and Kidney Transplant Recipients, the South West London Kidney Transplant Network Experience

Phanish, Mysore K.; Ster, Irina Chis; Ghazanfar, Abbas; Cole, Nicholas; Quan, Virginia; Hull, Richard; Banerjee, Debasish

doi:10.1016/j.ekir.2020.12.013

Cited by 31 publications

(29 citation statements)

References 23 publications

(80 reference statements)

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“…In other studies as well, stopping the anti‐proliferative has been the predominant immunosuppression modification strategy used in management of the transplant recipients with COVID‐19 while the calcineurin inhibitor (CNI) has been stopped in few severe cases. 6 , 22 , 27 , 28 Acute kidney injury was seen in 29.3% of the cases in the present study. Acute kidney injury has been reported to occur in 28%–77% of renal transplant patients with COVID‐19 infection in various studies.…”

Section: Discussionsupporting

confidence: 50%

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A retrospective multi‐center experience of renal transplants from India during COVID‐19 pandemic

Jha

Yadav

Siddini

et al. 2021

Clinical Transplantation

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Introduction Coronavirus disease 2019 (COVID‐19) pandemic led to a sudden drop in renal transplant numbers across India in the initial months of 2020. Although the transplant numbers increased with easing of lockdown, the outcome of these transplants remains unknown. Methods This was a retrospective, observational, multi‐center study done across eight different transplant centers in India. All the transplants done from January 30, 2020 to December 31, 2020 were included. The primary outcomes studied were patient and death censored graft survival as well as incidence of COVID‐19 infection and its outcomes. Results During the study period a total of 297 kidney transplants were done. After a median follow up of 265 days the patient and death censored graft survival was 95.3% and 97.6%, respectively. Forty‐one patients (13.8%) developed COVID‐19 post‐transplant. Majority (58.5%) were asymptomatic to mildly symptomatic and the case fatality ratio was 14.6%. On multivariable logistic regression analysis older age was associated with higher likelihood of COVID‐19 infection (odds ratio 1.038; CI 1.002–1.077). Conclusions Patient and graft outcome of kidney transplants done during the COVID‐19 pandemic in India was acceptable. The incidence of COVID‐19 was 13.8% with a high case fatality ratio.

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Section: Discussionsupporting

confidence: 50%

“…In a meta‐analysis by Phanish et al., a pooled case fatality ratio of 24% was seen. 22 In a regionwide registry study by Meester et al., the crude cumulative mortality rate was 14% in kidney transplant recipients. 3 The COVID‐19 related mortality was 26.8% in the Spanish Society of Nephrology registry data.…”

Section: Discussionmentioning

confidence: 97%

A retrospective multi‐center experience of renal transplants from India during COVID‐19 pandemic

Jha

Yadav

Siddini

et al. 2021

Clinical Transplantation

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“…allowing a broad-ranging overview and risk assessment for SARS-CoV-2-infected SOT recipients, which may help with addressing the many unanswered key questions urgently arising in this context [6] . Thus, we performed a structured literature review, providing an overview that compiles all relevant scientific literature from January 1 until December 31, 2020 to produce a current synoptic assessment of mortality and clinical outcomes subsequent to infection and COVID-19 in SOT recipients as well as a comprehensive summary of the relevant scientific literature that even a multitude of preceding systematic reviews fall short to provide so far [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] .…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

Quante

Brake

Tolios

et al. 2021

Transplantation Proceedings

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Background : The SARS-CoV-2 pandemic is challenging health systems all over the world. Particularly high-risk groups show considerable mortality rates after infection. In 2020, an inexorable number of case reports, case series and ultimately various systematic reviews have been published reporting on morbidity and mortality risk of SARS-CoV-2 in solid organ transplant (SOT) recipients. However, this vast array of publications resulted in an increasing complexity of the field, overwhelming even the expert reader. Methods : We performed a structured literature review comprising electronic databases, transplant journals and included literature from previous systematic reviews covering the entire year 2020. From 164 included articles we identified 3451 cases of SARS-CoV-2 infected SOT recipients. Results : Infections resulted in a hospitalization rate of 84% and 24% intensive care unit admissions (ICU) in the included patients. Whereas 53.6% of patients were reported to have recovered, cross-sectional overall mortality reported after COVID-19 was at 21.1%. Synoptic data concerning immunosuppressive medication attested to the reduction or withdrawal of antimetabolites (81.9%) and calcineurin inhibitors (48.9%) as a frequent adjustment. In contrast, steroids were reported to be increased in 46.8% of SOT patients. Conclusions : COVID-19 in SOT recipients is associated with high morbidity and mortality worldwide. Conforming with current guidelines, modifications of immunosuppressive therapies mostly comprised a reduction or withdrawal of antimetabolites and calcineurin inhibitors, while frequently maintaining or even increasing steroids. Here, we provide an accessible overview to the topic and synoptic estimates of expectable outcomes regarding in-hospital mortality of SOT patients diseased with COVID-19.

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“…12 A meta-analysis of 16 studies and 871 hospitalized kidney transplant patients with COVID-19 reported a pooled case fatality rate of 24%. 13 Additional similar retrospective studies conducted in Europe, Turkey, and the United States also showed similar increased risk of mortality due to COVID-19 with decreasing renal function, kidney failure, and transplantation. 2,3,9,14,15…”

Section: Does Adpkd Affect My Likelihood Of Hospitalization Need For Dialysis or Mortality If I Develop Covid-19?mentioning

confidence: 71%

The Impact of COVID-19 on Patients With ADPKD

Kutky

Cross

Treleaven

et al. 2021

Can J Kidney Health Dis

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Purpose of review: Patients with autosomal dominant polycystic kidney disease (ADPKD) have kidney cysts and kidney enlargement decades before progressing to advanced chronic kidney disease (CKD), meaning patients live most of their adult life with a chronic medical condition. The coronavirus disease 2019 (COVID-19) pandemic has created common questions among patients with ADPKD. In this review, we discuss COVID-19 concerns centered around a patient with a common clinical vignette. Sources of information: We performed PubMed and Google scholar searches for English, peer-reviewed studies related to “COVID-19,” “ADPKD,” “CKD,” “tolvaptan,” “angiotensin-converting enzyme inhibitors” (ACEi), “angiotensin receptor blockers” (ARB), and “vaccination.” We also evaluated transplant data provided by the Ontario Trillium Gift of Life Network. Methods: Following an assessment of available literature, this narrative review addresses common questions of patients with ADPKD in the context of the COVID-19 pandemic. Key findings: Data regarding the risk of developing COVID-19 and the risk of adverse COVID-19 outcomes in patients with ADPKD remain limited, but patients with ADPKD with impaired estimated glomerular filtration rate (eGFR), kidney transplants, or on dialysis are likely at similar increased risk as those with generally defined CKD. We provide strategies to improve virtual care, which is likely to persist after the pandemic. Current evidence suggests ACEi, ARB, and tolvaptan treatment should be continued unless contraindicated due to severe illness. When available, and in the absence of a severe allergy, vaccination is recommended for all patients with ADPKD. Limitations: This narrative review is limited by a paucity of high-quality data on COVID-19 outcomes in patients specifically with ADPKD. Implications: Patients with ADPKD who have developed advanced CKD, require dialysis, or who have received a kidney transplant are at elevated risk of COVID-19 complications.

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Systematic Review and Meta-analysis of COVID-19 and Kidney Transplant Recipients, the South West London Kidney Transplant Network Experience

Cited by 31 publications

References 23 publications

A retrospective multi‐center experience of renal transplants from India during COVID‐19 pandemic

A retrospective multi‐center experience of renal transplants from India during COVID‐19 pandemic

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020

The Impact of COVID-19 on Patients With ADPKD

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