Marinaki Smaragdi, Tsiakas Stathis, Korogiannou Maria, Grigorakos Konstantinos, Papalois Vassilios, Boletis Ioannis
Clinic of Nephrology and Renal Transplantation, National and Kapodistrian University of Athens Medical School, Laiko Hospital, 11527 Athens, Greece.
Independent Researcher, 12 Protopappa Avenue, 16345 Athens, Greece.
J Clin Med. 2020 Sep 16;9(9):2986. doi: 10.3390/jcm9092986.
The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to physicians and healthcare systems worldwide. Evidence about kidney transplant (KTx) recipients is still limited. A systematic literature review was performed. We included 63 articles published from 1 January until 7 July 2020, reporting on 420 adult KTx recipients with confirmed COVID-19. The mean age of patients was 55 ± 15 years. There was a male predominance (67%). The majority (74%) were deceased donor recipients, and 23% were recently transplanted (<1 year). Most patients (88%) had at least one comorbidity, 29% had two, and 18% three. Ninety-three percent of cases were hospitalized. Among them, 30% were admitted to the intensive care unit, 45% developed acute respiratory distress syndrome, and 44% had acute kidney injury with 23% needing renal replacement therapy. From the hospitalized patients a total of 22% died, 59% were discharged, and 19% were still in hospital at the time of publication. Immunosuppression was reduced in 27%, discontinued in 31%, and remained unchanged in 5%. Hydroxychloroquine was administered to 78% of patients, antibiotics to 73%, and antivirals to 30% while 25% received corticosteroid boluses, 28% received anti-interleukin agents, and 8% were given immunoglobulin. The main finding of our analysis was that the incidence of COVID-19 among kidney transplant patients is not particularly high, but when they do get infected, this is related to significant morbidity and mortality.
2019年冠状病毒病（COVID-19）大流行给全球医生和医疗系统带来了重大挑战。关于肾移植（KTx）受者的证据仍然有限。我们进行了一项系统的文献综述。我们纳入了2020年1月1日至7月7日发表的63篇文章，报道了420例确诊COVID-19的成年KTx受者。患者的平均年龄为55±15岁。男性占多数（67%）。大多数（74%）是已故供体受者，23%是近期移植的（<1年）。大多数患者（88%）至少有一种合并症，29%有两种，18%有三种。93%的病例住院治疗。其中，30%入住重症监护病房，45%发生急性呼吸窘迫综合征，44%发生急性肾损伤，23%需要肾脏替代治疗。在住院患者中，共有22%死亡，59%出院，19%在发表时仍住院。27%的患者免疫抑制降低，31%停药，5%保持不变。78%的患者使用了羟氯喹，73%使用了抗生素，30%使用了抗病毒药物，25%接受了皮质类固醇冲击治疗，28%接受了抗白细胞介素药物治疗，8%接受了免疫球蛋白治疗。我们分析的主要发现是，肾移植患者中COVID-19的发病率并不特别高，但当他们确实感染时，这与显著的发病率和死亡率相关。
