医学
2019年冠状病毒病(COVID-19)
重症监护医学
2019-20冠状病毒爆发
严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)
荟萃分析
器官移植
固体器官
电流(流体)
移植
病毒学
内科学
传染病(医学专业)
疾病
工程类
电气工程
爆发
作者
Mohammed Raja,Maria Elvira Alvarez Mendoza,Aasith Villavicencio,Shweta Anjan,John V. Reynolds,Veraprapas Kittipibul,Anmary Fernandez,Giselle Guerra,Jose F. Camargo,Jacques Simkins,Michele I. Morris,Lilian M. Abbo,Yoichiro Natori
标识
DOI:10.1016/j.trre.2020.100588
摘要
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 1 st t October 9 th , 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. • High rate of hospital and ICU admission amongst SOT recipients with COVID-19 • Fever maybe absent in up to 30% of SOT recipients with COVID-19. • Majority of centers held anti-metabolites in SOT patients with COVID-19. • Overall mortality in SOT recipients with COVID-19 was 20%.
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