COVID-19 in Solid Organ Transplant Recipients: a Review of the Current Literature

• Published in: Current treatment options in infectious disease 2021, Vol.13 (3), p.67-82
• Main Authors: Heldman, Madeleine R., Kates, Olivia S.
• Format: Article
• Language: English
• Subjects: Coronaviruses; COVID-19; COVID-19 vaccines; Epidemiology; Immunocompromised hosts; Immunosuppression; Infectious Diseases; Medicine; Medicine & Public Health; Pandemics; Section Editor; Severe acute respiratory syndrome coronavirus 2; Topical Collection on Transplant/Immunocompromised Hosts; Transplant/Immunocompromised Hosts (M Morales; Transplant/Immunocompromised Hosts (M Morales, Section Editor); Transplantation; Transplants & implants; Vaccines
• ISSN: 1523-3820; 1534-6250; 1534-6250
• DOI: 10.1007/s40506-021-00249-6

Purpose of review The approach to ongoing organ transplantation and management of COVID-19 in solid organ transplant recipients (SOTR) has evolved tremendously since the pandemic’s beginning. We summarize the current literature surrounding the virology of SARS-CoV-2, epidemiology of COVID-19 in transplant recipients, review the clinical features and complications of COVID-19 in SOTR, and discuss the safety and efficacy of current therapies and candidate vaccines in this population. Recent findings Despite initial suspensions in organ transplantation during early 2020, routine donor testing and de-crowding of hospitals have allowed transplant activity to resume at pre-pandemic rates. COVID-19-associated mortality in SOTR is similar to that of the general population, and lower than that of patients with end-organ disease awaiting transplant. The optimal approach to immunosuppression in SOTR with COVID-19 is unknown and disease severity may influence management decisions. Many vaccines in development are likely to be safe for immunocompromised hosts, though post-marketing investigations will be required to determine the efficacy in the SOTR. Summary Though there are multiple unique considerations in the care of SOTR with COVID-19, immunosuppression does not appear to have a detrimental impact on overall outcome. Organ transplantation remains a lifesaving intervention and can be safely performed despite a global pandemic.