Session Time: 4:30pm-5:30pm
Presentation Time: 4:45pm-4:50pm
*Purpose: Outcomes for solid organ transplants (SOT) with COVID-19 have not been summarized, and prognostic factors for COVID-19 in SOT patients are not well established yet.
*Methods: We searched PubMed, EMBASE, and Cochrane library up to November 10, 2020, to identify reports of SOT patients and COVID-19. This study was performed to estimate the risk of death and other important outcomes. Further, we also evaluated the risk factors associated with mortality and severe COVID-19 infection in SOT patients. Pooled prevalence, odds ratios (OR), and 95% confidence intervals (CI) were calculated using a random-effects model.
*Results: Fifty-nine studies involving 7071 SOT patients were included. 22% of SOT patients with COVID-19 were dead (20%-25%), 48% had acute kidney injury, 39% developed severe infection, 28% needed intensive care unit (ICU) admission, 35% had acute respiratory distress syndrome, and 23% needed invasive ventilation. Univariate analysis revealed that advanced age (OR=3.01, OR=2.97), obesity (OR=1.44, OR=2.05) and diabetes (OR=2.00, OR=1.73) were associated with severe infection and mortality. Laboratory abnormalities at admission including higher C reaction protein, D-Dimer, lactate dehydrogenase, procalcitonin, and lower lymphocyte also increased the risk of death. Initial MMF use (OR=1.61) contributed to severe infection, and tacrolimus (OR=1.70) led to more deaths. Further, calcinurin inhibitors withdrawal (OR=2.62), high dose steroids (OR=2.46), Tocilizumab (OR=1.75), ICU admission (OR=5.00), and invasive ventilation (OR=7.56) were associated with mortality.
*Conclusions: Our study demonstrated that SOT patients with COVID-19 had a high mortality and risk factors identification may contribute to patients stratification and management.
To cite this abstract in AMA style:Yin S, Song T, Zhong Q, Lin T. Mortality, Risk Factors, and Treatment of Covid-19 Infection in Solid Organ Transplants: A Systematic Review and Meta-analysis [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/mortality-risk-factors-and-treatment-of-covid-19-infection-in-solid-organ-transplants-a-systematic-review-and-meta-analysis/. Accessed June 18, 2021.
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