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.
【저자키워드】 COVID-19, Meta-analysis, SARS-CoV-2, COVID-19, Coronavirus disease 2019, Immunosuppression, systematic review, NP, nasopharyngeal, solid organ transplant, MERS, Middle East respiratory syndrome, CI, Confidence interval, RT-PCR, Reverse transcriptase-polymerase chain reaction, ICU, Intensive care unit, CRP, C-reactive protein, AKI, acute kidney injury, SOT, solid organ transplant, CNI, Calcineurin inhibitor, FEM, Fixed Effect Model, HSCT, Hematopoietic Stem Cell Transplant, IL-6, Interleukin Six, PRESS, Peer Review for Electronic Search Strategies, PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, REM, Random Effect Model, SARS, Severe Acute Respiratory Syndrome Coronavirus 1, SARS- CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2,