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Review
. 2021 Nov 4;10(21):5162.
doi: 10.3390/jcm10215162.

Incidence of Mortality, Acute Kidney Injury and Graft Loss in Adult Kidney Transplant Recipients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis

Jia-Jin Chen  1 , George Kuo  1 , Tao Han Lee  1 , Huang-Yu Yang  1   2 , Hsin Hsu Wu  1   2 , Kun-Hua Tu  1   2 , Ya-Chung Tian  1   2
Affiliations
Review

Incidence of Mortality, Acute Kidney Injury and Graft Loss in Adult Kidney Transplant Recipients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis

Jia-Jin Chen et al. J Clin Med. .

Abstract

The adverse impact of Coronavirus disease 2019 (COVID-19) on kidney function has been reported since the global pandemic. The burden of COVID-19 on kidney transplant recipients, however, has not been systematically analyzed. A systematic review and meta-analysis with a random-effect model was conducted to explore the rate of mortality, intensive care unit admission, invasive mechanical ventilation, acute kidney injury, kidney replacement therapy and graft loss in the adult kidney transplant population with COVID-19. Sensitivity analysis, subgroup analysis and meta-regression were also performed. Results: we demonstrated a pooled mortality rate of 21% (95% CI: 19-23%), an intensive care unit admission rate of 26% (95% CI: 22-31%), an invasive ventilation rate among those who required intensive care unit care of 72% (95% CI: 62-81%), an acute kidney injury rate of 44% (95% CI: 39-49%), a kidney replacement therapy rate of 12% (95% CI: 9-15%), and a graft loss rate of 8% (95% CI: 5-15%) in kidney transplant recipients with COVID-19. The meta-regression indicated that advancing age is associated with higher mortality; every increase in age by 10 years was associated with an increased mortality rate of 3.7%. Regional differences in outcome were also detected. Further studies focused on treatments and risk factor identification are needed.

Keywords: acute kidney injury; coronavirus disease 2019; graft loss; kidney replacement therapy; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Forest plot of pooled incidence of mortality in the adult kidney transplant population with COVID-19 infection.
Figure 2
Figure 2
Forest plot of secondary outcome in the adult kidney transplant population with COVID-19 infection.
Figure 3
Figure 3
Sensitivity analysis after excluding studies with moderate-to-high risk of bias ((A), upper) and forest plot of subgroup analysis ((B), lower).
Figure 4
Figure 4
Meta-regression according to sample size ((A), upper) and age ((B), lower).
See this image and copyright information in PMC

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