COVID-19 Mortality in Transplant Recipients.

Alfishawy, M; Elbendary, A; Mohamed, M; Nassar, M

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.