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

• Published in: Transplantation proceedings Vol. 53; no. 8; pp. 2421 - 2434
• Main Authors: Quante, Markus, Brake, Linda, Tolios, Alexander, Della Penna, Andrea, Steidle, Christoph, Gruendl, Magdalena, Grishina, Anna, Haeberle, Helene, Guthoff, Martina, Tullius, Stefan G., Königsrainer, Alfred, Nadalin, Silvio, Löffler, Markus W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2021; Published by Elsevier Inc
• Subjects: COVID-19 - epidemiology; Cross-Sectional Studies; Humans; Organ Transplantation; Pandemics; SARS-CoV-2; Transplant Recipients
• ISSN: 0041-1345; 1873-2623; 1873-2623
• DOI: 10.1016/j.transproceed.2021.08.019

•Comprehensive overview of the scientific literature published in 2020 on SARS-CoV-2 and/or COVID-19 in solid organ transplant (SOT) recipients.•More than 3400 SOT recipients with SARS-CoV-2 and/or COVID-19 compiled from the scientific literature, including clinical outcomes and management of immunosuppressive therapy provided in one article .•This outline provides a gateway to access the available literature rapidly as well as a broad ranging overview, for example, allowing for risk assessment within diverse contexts and locations.•Compiled data support the notion that clinical outcomes after SARS-CoV-2 infections in SOT recipients are poor, encouraging maintenance of adequate precautionary measures. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is challenging health systems all over the world. Particularly high-risk groups show considerable mortality rates after infection. In 2020, a huge number of case reports, case series, and consecutively various systematic reviews have been published reporting on morbidity and mortality risk connected with 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 for the expert reader. We performed a structured literature review comprising electronic databases, transplant journals, and 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. Infections resulted in a hospitalization rate of 84% and 24% intensive care unit admissions in the included patients. Whereas 53.6% of patients were reported to have recovered, cross-sectional overall mortality reported after coronavirus disease 2019 (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 recipients. 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 recipients with COVID-19.