Clinical insights into the role of immunosuppression and its disturbances in solid organ transplant recipients with coronavirus disease 2019

Kolonko, Aureliusz; Kuczaj, Agnieszka Anna; Musialik, Joanna; Słabiak-Błaż, Natalia; Hrapkowicz, Tomasz; Przybyłowski, Piotr; Wiȩcek, Andrzej

doi:10.20452/pamw.16139

Cited by 3 publications

(7 citation statements)

References 25 publications

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“…Overall, obesity was found to be present in 21% (95% CI: 15% to 28%) of the patients (Figure 2) and hypertension in 74% (95% CI: 66% to 80%) (Figure 3) of the patients. Additionally, investigating comorbidities, seven studies 12–18 reported pooled proportion of CAD of 18% (95% CI: 6% to 43%) (Figure 4); 10 studies 12,15,16,19–25 reported pooled proportion of CKD patients of 52% (95% CI: 40% to 63%; Figure 5) and 23 studies 12–34 reported a pooled proportion of patients with diabetes of 44% (95% CI: 37% to 51%; Figure 6). We identified 30 studies from our included studies to analyze all‐cause mortality.…”

Section: Resultsmentioning

confidence: 99%

“…Acute kidney injury (AKI) was reported in 13 studies, and the pooled AKI rate was 31% (95% CI: 26% to 37%) 12,15,17,21,26–29,32,36,39,41,42 [Figure 9]. Bajaut's plot showed study by Hadi Y et al unduly influenced heterogeneity and pooled estimates.…”

Section: Resultsmentioning

confidence: 99%

“…We identified 30 studies from our included studies to analyze allcause mortality. The pooled mortality was 17% (95% CI: 14% to 20%, I 2 = 96%); however, there was a significant heterogeneity and On performing subgroup analysis based on the type of transplant recipients (kidney, liver, heart, lung, or mixed), the mortality in kidney transplant recipients was 25% (95% CI: 0.18; 0.35; five studies), 13,14,35,36 14% (95% CI: 0.11; 0.18; 22 studies ) 12,15,16,18,19,21,[23][24][25][26][27][29][30][31][32][33][34][37][38][39][40][41] in mixed SOTRs; 20% (95% CI: 0.13; 0.29; one study) 28 in liver transplant recipients; 27% (95% CI: 0.13; 0.47; one study) 20 in heart transplant recipients; and 8% (95% CI: 0.01; 0.3; one study) 22 in lung transplant recipients. There was considerable heterogeneity (I 2 = 90%), and the test for subgroup difference was significant (Figure 7).…”

Section: Adult Studiesmentioning

confidence: 99%

“…Acute kidney injury (AKI) was reported in 13 studies, and the pooled AKI rate was 31% (95% CI: 26% to 37%) 12,15,17,21,[26][27][28][29]32,36,39,41,42 [Figure 9]. Bajaut's plot showed F I G U R E 1 PRISMA flow diagram for COVID-19 involvement in solid organ transplant recipients.…”

Section: Adult Studiesmentioning

confidence: 99%

“…Visual inspection of the funnel plot for publication bias showed asymmetry. Upon subgroup analysis based on the type of transplant recipients (kidney, liver, heart, lung, or mixed), the reported proportion of patients with AKI was 28% (95% CI: 0.22 to 0.36; 10 studies; I 2 = 92%) in studies reporting mixed SO TRs 12,15,17,21,26,27,29,32,39,41 ; 39% (95%CI: 0.35 to 0.44; two studies; I 2 = 0%) in kidney transplant recipients 36,42 and 31% (95% CI: 0.26 to 0.37; one study), 28 and the test for subgroup difference was significant (Figure 10).…”

Section: Adult Studiesmentioning

confidence: 99%

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The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

Raina

Shah

Marks

et al. 2023

Pediatric Transplantation

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Background The SARS‐CoV‐2 pandemic and corresponding acute respiratory syndrome have affected all populations and led to millions of deaths worldwide. The pandemic disproportionately affected immunocompromised and immunosuppressed adult patients who had received solid organ transplants (SOTs). With the onset of the pandemic, transplant societies across the world recommended reducing SOT activities to avoid exposing immunosuppressed recipients. Due to the risk of COVID‐19‐related outcomes, SOT providers adapted the way they deliver care to their patients, leading to a reliance on telehealth. Telehealth has helped organ transplant programs continue treatment regimens while protecting patients and physicians from COVID‐19 transmission. This review highlights the adverse effects of COVID‐19 on transplant activities and summarizes the increased role of telehealth in the management of solid organ transplant recipients (SOTRs) in both pediatric and adult populations. Methods A comprehensive systematic review and meta‐analysis were conducted to accentuate the outcomes of COVID‐19 and analyze the efficacy of telehealth on transplant activities. This in‐depth examination summarizes extensive data on the clinical detriments of COVID‐19 in transplant recipients, advantages, disadvantages, patient/physician perspectives, and effectiveness in transplant treatment plans via telehealth. Results COVID‐19 has caused an increase in mortality, morbidity, hospitalization, and ICU admission in SOTRs. Telehealth efficacy and benefits to both patients and physicians have increasingly been reported. Conclusions Developing effective systems of telehealth delivery has become a top priority for healthcare providers during the COVID‐19 pandemic. Further research is necessary to validate the effectiveness of telehealth in other settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Adult Studiesmentioning

confidence: 99%

Section: Adult Studiesmentioning

confidence: 99%

Section: Adult Studiesmentioning

confidence: 99%

See 3 more Smart Citations

The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

Raina

Shah

Marks

et al. 2023

Pediatric Transplantation

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Serologic Status According Severe Acute Respiratory Syndrome Coronavirus 2 in Patients After Orthotopic Heart Transplantation

Kuczaj

Przybyłowski

2022

Transplantation Proceedings

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New Scenarios in Heart Transplantation and Persistency of SARS-CoV-2 (Case Report)

Mitrofanova

Makarov

Горшков

et al. 2023

Life

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Heart transplantation is a treatment of choice for patients with severe heart failure. Infection transmission from a donor to a recipient remains a prominent problem in organ transplantation. However, the risk of SARS-CoV-2 transmission in nonlung organ transplantation is still unclear. In this article we presented a case of a 28-year-old pregnant woman who developed heart failure soon after recovery from a SARS-CoV-2 infection in the third trimester of gestation. In the postpartum period, the heart disease worsened and the patient required cardiac transplantation. We examined the recipient’s heart and made a diagnosis of left ventricular noncompaction cardiomyopathy. Immunohistochemical analysis showed SARS-CoV-2 antigen expression in the donor’s heart before transplantation, and after the transplantation, an endomyocardial biopsy was taken. Moreover, an ultrastructural assessment of the endomyocardial specimen revealed endothelial and pericyte injury and a single particle on the surface of the endothelium consistent with SARS-CoV-2 viral particles. Recent findings in the literature associated these damages with SARS-CoV-2 infection. The present study describes the rare case of SARS-CoV-2 transmission from donor to postpartum recipient through a heart transplant and demonstrates the importance of endomyocardial biopsy before and after heart transplantation.

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Clinical insights into the role of immunosuppression and its disturbances in solid organ transplant recipients with coronavirus disease 2019

Cited by 3 publications

References 25 publications

The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

The effects of COVID‐19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth

Serologic Status According Severe Acute Respiratory Syndrome Coronavirus 2 in Patients After Orthotopic Heart Transplantation

New Scenarios in Heart Transplantation and Persistency of SARS-CoV-2 (Case Report)

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