COVID-19 in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis of Current Literature

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