Mihai Oltean1,2, John Mackay Søfteland1,2, Jasmine Bagge1,2, Jan Ekelund3, Marie Felldin1, Andreas Schult1,4, Jesper Magnusson1, Vanda Friman5, Kristjan Karason1,4. 1. Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden. 2. Department of Surgery, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 3. Centre of Registers Västra Götaland, Gothenburg, Sweden. 4. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 5. Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) ranges from a mild illness to acute respiratory distress syndrome (ARDS), multiorgan dysfunction, and death. Transplant recipients are vulnerable due to comorbidities and immunosuppressants that render them susceptible to infections. The information on COVID-19 in kidney transplant recipients remains limited to small case series. METHODS: A systematic literature search was conducted, and 12 case series totalling 204 kidney transplant recipients with COVID-19 were identified. Data were extracted, pooled and analysed. RESULTS: Most patients (74%) were men. The most frequent symptoms were fever (76%), cough (64%) and dyspnoea (43%). At admission, over 70% of the patients had abnormal radiological findings. Leukocyte counts were in the lower normal range. C-reactive protein, ferritin, and D-dimer were consistently increased. Treatments included lowering immunosuppression, hydroxychloroquine, antivirals, tocilizumab and intravenous immunoglobulins. Thirty-one percent of the patients were admitted to intensive care units (ICUs), and 16% required intubation. The overall mortality was 21.2%. Patients who died were significantly older than those who survived (61 ± 12 vs. 51 ± 15, p < .01). Logistic regression revealed that the odds for death increased by 4.3% for each additional year of age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.005-1.083, p value = .0265). CONCLUSIONS: No substantial conclusions could be drawn on the efficacy of any particular treatment. More rigorous patient stratification is needed when analysing and reporting data to facilitate future meta-analyses.
BACKGROUND:Coronavirus disease 2019 (COVID-19) ranges from a mild illness to acute respiratory distress syndrome (ARDS), multiorgan dysfunction, and death. Transplant recipients are vulnerable due to comorbidities and immunosuppressants that render them susceptible to infections. The information on COVID-19 in kidney transplant recipients remains limited to small case series. METHODS: A systematic literature search was conducted, and 12 case series totalling 204 kidney transplant recipients with COVID-19 were identified. Data were extracted, pooled and analysed. RESULTS: Most patients (74%) were men. The most frequent symptoms were fever (76%), cough (64%) and dyspnoea (43%). At admission, over 70% of the patients had abnormal radiological findings. Leukocyte counts were in the lower normal range. C-reactive protein, ferritin, and D-dimer were consistently increased. Treatments included lowering immunosuppression, hydroxychloroquine, antivirals, tocilizumab and intravenous immunoglobulins. Thirty-one percent of the patients were admitted to intensive care units (ICUs), and 16% required intubation. The overall mortality was 21.2%. Patients who died were significantly older than those who survived (61 ± 12 vs. 51 ± 15, p < .01). Logistic regression revealed that the odds for death increased by 4.3% for each additional year of age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.005-1.083, p value = .0265). CONCLUSIONS: No substantial conclusions could be drawn on the efficacy of any particular treatment. More rigorous patient stratification is needed when analysing and reporting data to facilitate future meta-analyses.
Authors: John M Søfteland; Gustav Friman; Bengt von Zur-Mühlen; Bo-Göran Ericzon; Carin Wallquist; Kristjan Karason; Vanda Friman; Jan Ekelund; Marie Felldin; Jesper Magnusson; Ida Haugen Löfman; Andreas Schult; Emily de Coursey; Susannah Leach; Hanna Jacobsson; Jan-Åke Liljeqvist; Ali R Biglarnia; Per Lindnér; Mihai Oltean Journal: Am J Transplant Date: 2021-05-06 Impact factor: 9.369
Authors: Jesper M Magnusson; Hillevi Larsson; Ahmed Alsaleh; Jan Ekelund; Kristjan Karason; Andreas Schult; Vanda Friman; Marie Felldin; John Mackay Søfteland; Göran Dellgren; Mihai Oltean Journal: Transpl Int Date: 2021-11-14 Impact factor: 3.842
Authors: Mohamad M Alkadi; Hassan A Al-Malki; Muhammad Asim; Omar M Fituri; Ahmed F Hamdi; Rihab I Elidrisi; Ramzi Abdul Rahiman; Mostafa F Elshirbeny; Muftah A Othman; Awais Nauman; Adel Ashour; Tarek A Ghonimi; Hiba Tohid; Mona E Jarman; Abdullah Hamad; Mohamed B Elshazly; Essa Abuhelaiqa Journal: Transplant Proc Date: 2021-06-11 Impact factor: 1.066