TY - JOUR
T1 - A systematic review and meta-analysis of COVID-19 in kidney transplant recipients
T2 - Lessons to be learned
AU - Kremer, Daan
AU - Pieters, Tobias T.
AU - Verhaar, Marianne C.
AU - Berger, Stefan P.
AU - Bakker, Stephan J.L.
AU - van Zuilen, Arjan D.
AU - Joles, Jaap A.
AU - Vernooij, Robin W.M.
AU - van Balkom, Bas W.M.
N1 - Publisher Copyright:
© 2021 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2021/12
Y1 - 2021/12
N2 - Kidney transplant recipients (KTR) may be at increased risk of adverse COVID-19 outcomes, due to prevalent comorbidities and immunosuppressed status. Given the global differences in COVID-19 policies and treatments, a robust assessment of all evidence is necessary to evaluate the clinical course of COVID-19 in KTR. Studies on mortality and acute kidney injury (AKI) in KTR in the World Health Organization COVID-19 database were systematically reviewed. We selected studies published between March 2020 and January 18th 2021, including at least five KTR with COVID-19. Random-effects meta-analyses were performed to calculate overall proportions, including 95% confidence intervals (95% CI). Subgroup analyses were performed on time of submission, geographical region, sex, age, time after transplantation, comorbidities, and treatments. We included 74 studies with 5559 KTR with COVID-19 (64.0% males, mean age 58.2 years, mean 73 months after transplantation) in total. The risk of mortality, 23% (95% CI: 21%–27%), and AKI, 50% (95% CI: 44%–56%), is high among KTR with COVID-19, regardless of sex, age and comorbidities, underlining the call to accelerate vaccination programs for KTR. Given the suboptimal reporting across the identified studies, we urge researchers to consistently report anthropometrics, kidney function at baseline and discharge, (changes in) immunosuppressive therapy, AKI, and renal outcome among KTR.
AB - Kidney transplant recipients (KTR) may be at increased risk of adverse COVID-19 outcomes, due to prevalent comorbidities and immunosuppressed status. Given the global differences in COVID-19 policies and treatments, a robust assessment of all evidence is necessary to evaluate the clinical course of COVID-19 in KTR. Studies on mortality and acute kidney injury (AKI) in KTR in the World Health Organization COVID-19 database were systematically reviewed. We selected studies published between March 2020 and January 18th 2021, including at least five KTR with COVID-19. Random-effects meta-analyses were performed to calculate overall proportions, including 95% confidence intervals (95% CI). Subgroup analyses were performed on time of submission, geographical region, sex, age, time after transplantation, comorbidities, and treatments. We included 74 studies with 5559 KTR with COVID-19 (64.0% males, mean age 58.2 years, mean 73 months after transplantation) in total. The risk of mortality, 23% (95% CI: 21%–27%), and AKI, 50% (95% CI: 44%–56%), is high among KTR with COVID-19, regardless of sex, age and comorbidities, underlining the call to accelerate vaccination programs for KTR. Given the suboptimal reporting across the identified studies, we urge researchers to consistently report anthropometrics, kidney function at baseline and discharge, (changes in) immunosuppressive therapy, AKI, and renal outcome among KTR.
KW - clinical research/practice
KW - complication: infectious
KW - immunosuppressive regimens
KW - infection and infectious agents - viral
KW - infectious disease
KW - kidney transplantation/nephrology
KW - meta-analysis
KW - translational research/science
UR - http://www.scopus.com/inward/record.url?scp=85110469485&partnerID=8YFLogxK
U2 - 10.1111/ajt.16742
DO - 10.1111/ajt.16742
M3 - Review article
C2 - 34212499
SN - 1600-6135
VL - 21
SP - 3936
EP - 3945
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 12
ER -