Effect of immunosuppression maintenance in solid organ transplant recipients with COVID‐19: Systematic review and meta‐analysis Article Swipe
Arta Karruli
,
Serenella Spiezia
,
Filomena Boccia
,
Massimo Gagliardi
,
Fabian Patauner
,
Anna Salemme
,
Ciro Maiello
,
Rosa Zampino
,
Emanuele Durante‐Mangoni
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1111/tid.13595
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1111/tid.13595
Background The aim of this study was to assess the effect of continuing immune suppressive therapy in solid organ transplant recipients (SOTR) with coronavirus disease 2019 (COVID‐19). Methods Systematic review and meta‐analysis of data on 202 SOTR with COVID‐19, published as case reports or case series. We extracted clinical, hemato‐chemical, imaging, treatment, and outcome data. Results Most patients were kidney recipients (61.9%), males (68.8%), with median age of 57 years. The majority was on tacrolimus (73.5%) and mycophenolate (65.8%). Mortality was 18.8%, but an equal proportion was still hospitalized at last follow up. Immune suppressive therapy was withheld in 77.2% of patients, either partially or completely. Tacrolimus was continued in 50%. One third of survivors that continued immunosuppressants were on dual therapy plus steroids. None of those who continued immunosuppressants developed critical COVID‐19 disease. Age (OR 1.07, 95% CI 1‐1.11, P = .001) and lopinavir/ritonavir use (OR 3.3, 95%CI 1.2‐8.5, P = .013) were independent predictors of mortality while immunosuppression maintenance (OR 0.067, 95% CI 0.008‐0.558, P = .012) and tacrolimus continuation (OR 0.3, 95% CI 0.1‐0.7, P = .013) were independent predictors of survival. Conclusions Our data suggest that maintaining immune suppression might be safe in SOTR with moderate and severe COVID‐19. Specifically, receiving tacrolimus could be beneficial for COVID‐19 SOTR. Because of the quality of the available evidence, no definitive guidance on how to manage SOTR with COVID‐19 can be derived from our data.
Related Topics
Concepts
Medicine
Immunosuppression
Tacrolimus
Internal medicine
Meta-analysis
Coronavirus disease 2019 (COVID-19)
Mycophenolic acid
Transplantation
Disease
Infectious disease (medical specialty)
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1111/tid.13595
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tid.13595
- OA Status
- bronze
- Cited By
- 25
- References
- 97
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3135723690
All OpenAlex metadata
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https://openalex.org/W3135723690Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/tid.13595Digital Object Identifier
- Title
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Effect of immunosuppression maintenance in solid organ transplant recipients with COVID‐19: Systematic review and meta‐analysisWork title
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reviewOpenAlex work type
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enPrimary language
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2021Year of publication
- Publication date
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2021-02-28Full publication date if available
- Authors
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Arta Karruli, Serenella Spiezia, Filomena Boccia, Massimo Gagliardi, Fabian Patauner, Anna Salemme, Ciro Maiello, Rosa Zampino, Emanuele Durante‐MangoniList of authors in order
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https://doi.org/10.1111/tid.13595Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tid.13595Direct link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/tid.13595Direct OA link when available
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Medicine, Immunosuppression, Tacrolimus, Internal medicine, Meta-analysis, Coronavirus disease 2019 (COVID-19), Mycophenolic acid, Transplantation, Disease, Infectious disease (medical specialty)Top concepts (fields/topics) attached by OpenAlex
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25Total citation count in OpenAlex
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2025: 2, 2024: 4, 2023: 2, 2022: 9, 2021: 8Per-year citation counts (last 5 years)
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97Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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