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

• Published in: Transplantation proceedings 2021-10, Vol.53 (8), p.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: Article
• Language: English
• 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