The Impact of Covid-19 in Kidney Transplant Recipients: A Systematic Review and Meta-analysis

J. Kumar¹, J. Pyda², I. Reccia³, F. VIrdis⁴, P. Bachul¹, R. Barth¹, Y. Becker¹, J. Fung¹, P. Witkowski¹

¹University of Chicago, Chicago, IL, ²Beth Israel, Boston, MA, ³Imperial College, London, United Kingdom, ⁴Royal London, London, United Kingdom

Meeting: 2021 American Transplant Congress

Abstract number: 64

Keywords: Infection, Kidney, Kidney transplantation, N/A

Topic: Clinical Science » Infectious Disease » Kidney Infectious Non-Polyoma & Non-Viral Hepatitis

Session Information

Session Name: COVID-19 in Kidney Recipients

Session Type: Rapid Fire Oral Abstract

Date: Saturday, June 5, 2021

Session Time: 6:00pm-7:00pm

Presentation Time: 6:25pm-6:30pm

Location: Virtual

*Purpose: To determine pooled prevalence of clinical outcomes among hospitalized kidney transplant recipients with COVID-19 through meta-analysis.

*Methods: A systematic database search between Dec1, 2019- Dec1, 2020, revealed twenty-nine studies, 875 renal transplant patients with COVID-19.

*Results: The most prevalent symptoms were fever(83%), cough(65%), dyspnea(46%) and gastrointestinal(27%). The frequently observed co-morbidities were hypertension(86%), DM2 (34%), and cardiac disease(26%)(Table1,2). In-hospital mortality was 23%(95%CI,17%-29%); while, it increased significantly in ICU admissions 58%(95%CI,43%-74%) (P≤0.001)(Fig1A,B). Further, sub-group analysis showed significantly increased mortality risk in elderly(OR=3.40); however, no such association was observed in terms of time since transplant and gender(Fig1C-E).

*Conclusions: To recapitulate, we observed a higher prevalence of dyspnea and gastrointestinal symptoms to general population. In-hospital mortality was similar to non-transplant population with high co-morbidities alongside and considered as important determinants of increased critical care admission, invasive ventilatory requirement. In-addition, observed higher mortality in elderly could be because of age-associated comorbidities.

Table 1: Summary statistics outlined as pooled estimates of outcomes of interest.
Attribute	Events	Total	Studies	Single group summary (95%CI)
Age(yrs)	NA	829	28	57.14 (54.49 – 59.80)
Male	573	875	29	0.70 (0.65 – 0.75)
DM2	260	659	22	0.34 (0.26 – 0.42)
Hypertension	564	648	22	0.86 (0.81 – 0.92)
Heart disease	158	615	18	0.26 (0.18 – 0.34)
Lung disease	147	495	10	0.20 (0.02 – 0.42)
Radiological evidence of pneumonia	385	529	23	0.84 (0.76 – 0.92)

Table 2: Summary statistics outlined as pooled estimate of outcomes of interests
Attribute	Events	Total	Studies	Single group summary (95%CI)
Fever	420	541	21	0.83 (0.76 – 0.90)
Cough	304	485	19	0.65 (0.57 – 0.73)
Dyspnea	239	537	21	0.46 (0.37 – 0.56)
Gastrointestinal symptoms	158	529	20	0.27 (0.22 – 0.33)
CNI withheld/reduced	246	618	22	0.50 (0.30 – 0.71)
MMF withheld/reduced	461	554	22	0.89 (0.84 – 0.94)
Increase/pulse steroid	191	504	18	0.38 (0.23 – 0.54)

To cite this abstract in AMA style:

Kumar J, Pyda J, Reccia I, VIrdis F, Bachul P, Barth R, Becker Y, Fung J, Witkowski P. The Impact of Covid-19 in Kidney Transplant Recipients: A Systematic Review and Meta-analysis [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-covid-19-in-kidney-transplant-recipients-a-systematic-review-and-meta-analysis/. Accessed November 22, 2024.

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