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Published on: August 15, 2022
COVID-19 Mortality in Transplant Recipients
M Alfishawy1,2, A Elbendary3, M Mohamed4
1Infectious Diseases Consultants and Academic Researchers of Egypt (IDCARE), Cairo, Egypt.
Insights
Organ transplant recipients face high mortality from COVID-19, with a 20% death rate observed in this study. Outcomes varied by country and were worse in older patients with comorbidities.
Area of Science:
- Transplant medicine
- Infectious diseases
- Public health
Background:
- Organ transplant recipients are immunocompromised and highly susceptible to infections.
- The emergence of SARS-CoV-2 (COVID-19) posed a significant threat to this vulnerable population.
- Previous data on COVID-19 outcomes in transplant patients were limited.
Purpose of the Study:
- To assess the mortality rate of COVID-19 in organ transplant recipients.
- To identify factors associated with mortality in this patient group.
Main Methods:
- A systematic literature review was performed using PubMed and Google Scholar.
- Studies published between January 1, 2020, and May 7, 2020, focusing on COVID-19 in transplant recipients were included.
- Data from 46 articles encompassing 320 transplant patients were analyzed.
Main Results:
- The overall COVID-19 mortality rate among transplant recipients was 20%.
- Mortality varied across different organ transplant types (kidney, liver, heart, lung) and geographical regions.
- Older age, male sex, and pre-existing conditions like hypertension and diabetes were common among deceased patients, with acute respiratory distress syndrome being the most frequent cause of death.
Conclusions:
- Organ transplant recipients experienced a high mortality rate due to COVID-19.
- Outcomes were influenced by country-specific outbreak settings and patient comorbidities.
- Elderly transplant recipients with comorbidities represent a particularly high-risk group for severe COVID-19 outcomes.
Background:
Organ transplant recipients are vulnerable to multiple infectious agents and in a world with a circulating SARS-CoV-2 virus, it would be expected that patients who are immunosuppressed would have higher mortality.
Objective:
To determine the COVID-19 mortality in transplant recipients.
Methods:
We conducted a search in PubMed and Google scholar databases using the keywords for COVID-19 and transplantation. All related studies between January 1, 2020 and May 7, 2020 were reviewed. All relevant published articles related to COVID-19 in transplant recipients were included.
Results:
46 articles were included; they studied a total of 320 transplant patients-220 kidney transplant recipients, 42 liver, 19 heart, 22 lung, 8 HSCT, and 9 dual organ transplant recipients. The overall mortality rate was 20% and was variable among different organs and different countries. 65 transplant recipients died of complications attributable to COVID-19; 33 were males (15% of males in this cohort), 8 females (8% of females in this cohort), and 24 whose sex was not determined. They had a median age of 66 (range: 32-87) years. The median transplantation duration was 8 years (range: 30 days to 20 years). The most frequent comorbidity reported was hypertensions followed by diabetes mellitus, obesity, malignancy, ischemic heart disease, and chronic obstructive pulmonary disease. The most frequent cause of death reported was acute respiratory distress syndrome.
Conclusion:
Transplant recipients in our cohort had a high mortality rate. However, outcomes were not the same in different countries based on outbreak settings. Mortality was noted in elder patients with comorbidities.
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