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A Systematic Review of COVID-19 Infection in Kidney Transplant Recipients: A Universal Effort to Preserve Patients’ Lives and Allografts

1
Clinic of Nephrology and Renal Transplantation, National and Kapodistrian University of Athens Medical School, Laiko Hospital, 11527 Athens, Greece
2
Independent Researcher, 12 Protopappa Avenue, 16345 Athens, Greece
3
Renal and Transplant Directorate, Imperial College Healthcare NHS Trust, London W12 0HS, UK
4
Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 2986; https://doi.org/10.3390/jcm9092986
Received: 21 August 2020 / Revised: 8 September 2020 / Accepted: 10 September 2020 / Published: 16 September 2020
(This article belongs to the Section Infectious Diseases)
The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to physicians and healthcare systems worldwide. Evidence about kidney transplant (KTx) recipients is still limited. A systematic literature review was performed. We included 63 articles published from 1 January until 7 July 2020, reporting on 420 adult KTx recipients with confirmed COVID-19. The mean age of patients was 55 ± 15 years. There was a male predominance (67%). The majority (74%) were deceased donor recipients, and 23% were recently transplanted (<1 year). Most patients (88%) had at least one comorbidity, 29% had two, and 18% three. Ninety-three percent of cases were hospitalized. Among them, 30% were admitted to the intensive care unit, 45% developed acute respiratory distress syndrome, and 44% had acute kidney injury with 23% needing renal replacement therapy. From the hospitalized patients a total of 22% died, 59% were discharged, and 19% were still in hospital at the time of publication. Immunosuppression was reduced in 27%, discontinued in 31%, and remained unchanged in 5%. Hydroxychloroquine was administered to 78% of patients, antibiotics to 73%, and antivirals to 30% while 25% received corticosteroid boluses, 28% received anti-interleukin agents, and 8% were given immunoglobulin. The main finding of our analysis was that the incidence of COVID-19 among kidney transplant patients is not particularly high, but when they do get infected, this is related to significant morbidity and mortality. View Full-Text
Keywords: COVID-19 infection; kidney transplantation; outcomes; immunosuppression; treatment COVID-19 infection; kidney transplantation; outcomes; immunosuppression; treatment
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MDPI and ACS Style

Marinaki, S.; Tsiakas, S.; Korogiannou, M.; Grigorakos, K.; Papalois, V.; Boletis, I. A Systematic Review of COVID-19 Infection in Kidney Transplant Recipients: A Universal Effort to Preserve Patients’ Lives and Allografts. J. Clin. Med. 2020, 9, 2986.

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