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The COVID-19 pandemic has had a striking impact on kidney transplantation globally. Patients with chronic kidney disease (CKD) and kidney transplant patients are one of the populations most vulnerable to the risks of COVID-19. In the United States alone, there are more than half a million people living with end stage renal disease (ESRD).
More than 105,234 kidney transplants were performed in 2019 all over the globe. After the outbreak of COVID-19, all surgeries were stopped as an early response to the pandemic. A drastic fall in the number of kidney transplants was observed, with a fall rate of 59.2% from the 105,234-plus kidney transplants (KTx) in 2019 to 42,948 KTx in 2020.
Study | Place | Sample Size (N) * | Clinical Presentation # | Treatments # | Immunosuppression Adjustment # | Mortality |
---|---|---|---|---|---|---|
Abreshami et al., 2020 [28] | Iran | 12 | fever, cough, myalgia, headache, shortness of breath, gastrointestinal symptoms | HCQ, LR, AB, Ig | Decrease in MMF/AZT, MMF and CNI | 8 |
Akalin et al., 2020 [26] | USA | 36 | fever, cough, myalgia, diarrhea, shortness of breath | HCQ, AZ, TL, LL | Withdrawal of F and AMB | 10 |
Azzi et al., 2020 [41] | USA | 229 | - | HCQ, AB, RD, TL, CP, AK, Ig, LL, SL, AC | Withdrawal of AMB, CNI | 47 |
Banerjee et al., 2020 [38] | UK | 7 | fever, cough, diarrhea, emesis, shortness of breath | - | Withdrawal of MMF and FK | 1 |
Caillard et al., 2021 [31] | France | 273 | fever, cough, diarrhea, headache, shortness of breath, loss of smell/taste | HCQ, AZ, LR, OR, TL, RD, AB, AF | Withdrawal of CNI, mTOR, AMB and BC | - |
Chavarot et al., 2021 [30] | France | 100 | fever, cough, myalgia, diarrhea, shortness of breath, loss of smell/taste | HCQ, AZ, TL | Withdrawal of CNI, AMB and BC | 26 |
Coll et al., 2021 [42] | Spain | 375 | HCQ, AZ, AK, AV | CNI, AMB and mTOR adjustments | 103 | |
Cravedi et al., 2020 [36] | USA | 144 | fever, myalgia, diarrhea, shortness of breath, | HCQ, AB, TL, RD, LR, DC, DR | Withdrawal of FK, MMF | 46 |
Cucchiari et al., 2020 [33] | Spain | 28 | fever, cough, shortness of breath, gastrointestinal symptoms, loss of smell/taste | HCQ, AZ, LR, TL, Steroids | Withdrawal of MPA/mTOR and CNI | 5 |
Dheir et al., 2021 [39] | Turkey | 20 | fever, cough, shortness of breath, myalgia, diarrhea | HCQ, FR, DX, ORCP, AB | Withdrawal of AMB, CNI, mTOR | 2 |
Elhadedy et al., 2020 [35] | UK | 8 | fever, cough, shortness of breath | - | Discontinued MMF, increase/decrease in FK | No death |
Elias et al., 2020 [14] | France | 66 | fever, cough, diarrhea, shortness of breath, loss of smell/taste | HCQ, TL, EL | Withdrawal of MMF/MPA/AZ, CNI | 16 |
Fung et al., 2021 [43] | USA | 4 | fever, cough, diarrhea, fatigue, shortness of breath | HCQ, LR, TL, AB, RD, CP, Steroids | Withdrawal of MPA, FK, MPA | No death |
Gandolfini et al., 2020 [24] | Italy | 2 | fever, myalgia, diarrhea, shortness of breath | HCQ, AB, LR, DC, RD | Withdrawal of Tac and MMF | 1 |
Giorgakis et al., 2020 [37] | USA | 4 | fever, cough, loss of smell/taste, emesis, throat pain, fatigue, headache, loss of appetite, rhinorrhea | HCQ, AZ, TL | Decrease in FK, MMF, MPA, CNI | 1 |
Kute et al., 2021 [32] | India | 250 | fever, cough, myalgia, fatigue, headache, emesis, diarrhea, shortness of breath, gastrointestinal symptoms, loss of smell/taste, throat pain, Z, rhinorrhea, loss of appetite, altered mental state | HCQ, AZ, FR, RD, CP, Ig | Withdrawal of and decrease in AMB, decrease in CNI and increase in PS | 29 |
Mamode et al., 2021 [25] | UK | KTx = 121, W/L = 52 |
fever, cough, myalgia, fatigue, headache, emesis, diarrhea, shortness of breath, | - | - | KTx-36 W/L-12 |
Naeem et al., 2020 [44] | USA | 3 | fever, chills, fatigue, diarrhea, shortness of breath, emesis, gastrointestinal symptoms | CP, CFT, AZ, VM, PT, RD | Withdrawal of MMF, AZT | No deaths |
Nair et al., 2020 [19] | USA | 10 | fever, cough, chills, myalgia, nasal congestion, fatigue, headache, emesis, diarrhea, shortness of breath | HCQ, AZ | Decrease in MPA, MMF and FK | 3 |
Oto et al., 2021 [23] | Turkey | 109 | fever, cough, myalgia, fatigue, headache, diarrhea, shortness of breath, throat pain | HCQ, OR, LR, FR, GC, TL, AK, AP | - | 14 |
Rinaldi et al., 2020 [27] | Italy | 24 (22 KTx) |
fever, cough, diarrhea, shortness of breath | HCQ, AZ, DC, TL, Steroids | 4 (30 days) |
|
Schapiro et al., 2021 [40] | USA | KTx = 80 W/L = 56 |
fever, cough, diarrhea, emesis, headache, fatigue, myalgia, shortness of breath, | HCQ, AZ, RD, TL, SX, CP, DY | Withdrawal of, increase or decrease in MMF | KTx = 13 W/L = 19 |
Shrivastava et al., 2021 [34] | USA | 39 | fever, cough, diarrhea, headache, altered mental state, hypoxia | HCQ, TL | Withdrawal of or decrease in AMB and CNI | 9 |
Zhang et al., 2020 [29] | China | 5 | fever, cough, myalgia, fatigue | OR, AB, Ig | Decrease in GC, MMF and CNI | No deaths |