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Meta-Analysis
. 2023 Feb:76:101739.
doi: 10.1016/j.trim.2022.101739. Epub 2022 Nov 19.

Predictor factor for worse outcomes in kidney transplant recipients infected with coronavirus disease 2019: A systematic review and meta-analysis

Gede Wirya Kusuma Duarsa  1 , Ronald Sugianto  2 , I Gusti Agung Ayu Andra Yusari  3 , Pande Made Wisnu Tirtayasa  4 , Gerhard Reinaldi Situmorang  5 , Nur Rasyid  6 , Arry Rodjani  7 , Besut Daryanto  8 , Kurnia Penta Seputra  9 , Paksi Satyagraha  10
Affiliations
Meta-Analysis

Predictor factor for worse outcomes in kidney transplant recipients infected with coronavirus disease 2019: A systematic review and meta-analysis

Gede Wirya Kusuma Duarsa et al. Transpl Immunol. 2023 Feb.

Abstract

Introduction: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a massive impact on the health sector, especially in patients with pre-existing comorbidities. This study aims to define the predictor factors for worse outcomes in kidney transplant patients infected with SARS-CoV-2 and affected by coronavirus disease 2019 (COVID-19). We have analyzed in these patients their prior medical history, their clinical symptoms, and their laboratory results.

Method: We assessed outcomes of kidney transplant patients with confirmed COVID-19 until July 2021 from PubMed, Medline, Science Direct, Cochrane databases, EMBASE, Scopus, and EBSCO. We performed meta-analyses of nine published studies to estimate predictor factors. The analysis was analyzed by the Newcastle-Ottawa Scale (NOS) and then using the Review Manager 5.4 software.

Result: Our analysis demonstrated that the most significant risk factors for the worse COVID-19 outcomes for kidney transplant patients included: age of 60 and older [MD 9.31(95% CI, 6.31-12.30), p < 0.0001, I2 = 76%], diabetic nephropathy [OR 2.13 (95% CI, 1.49-3.04), p < 0.0001, I2 = 76%], dyspnea [OR 4.53, (95% CI, 2.22-9.22), p < 0.0001, I2 = 76%], acute kidney injury (AKI) [OR 4.53 (95% CI, 1.10-5.21), p = 0.03, I2 = 58%], and some laboratory markers. Many patients had two or multiple risk factors in combination.

Conclusion: Age and several comorbidities were the most significant factors for COVID-19 outcomes for kidney transplant recipients.

Keywords: COVID-19; Kidney transplant; Meta-analysis; Outcome; Risk factor; Systematic review.

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Conflict of interest statement

Declaration of Competing Interest The author declares that he has no conflict of interest.

Figures

Fig. 1
Fig. 1
The Flowchart of Literature Research.
Fig. 2
Fig. 2
Older Age showed significance as the predictor values of worse outcomes. Deceased Donor and Diabetic Nephropathy are also significant as the predictor values.
Fig. 3
Fig. 3
Comorbid and Symptoms that significant A. Diabetes, hypertension, heart disease, and HIV are comorbid and significant for predicting the worsening symptoms B. AKI and dyspnea were the significant symptoms as the predictor values of worse outcomes.
Fig. 3
Fig. 3
Comorbid and Symptoms that significant A. Diabetes, hypertension, heart disease, and HIV are comorbid and significant for predicting the worsening symptoms B. AKI and dyspnea were the significant symptoms as the predictor values of worse outcomes.
Fig. 4
Fig. 4
The significant values of laboratory examination as the predictor values of worsening symptoms. A. Laboratory values in poor outcome patients showed lower than another group. B. The elevated laboratory values showed in worse outcome patients.
Fig. 4
Fig. 4
The significant values of laboratory examination as the predictor values of worsening symptoms. A. Laboratory values in poor outcome patients showed lower than another group. B. The elevated laboratory values showed in worse outcome patients.
Fig. 4
Fig. 4
The significant values of laboratory examination as the predictor values of worsening symptoms. A. Laboratory values in poor outcome patients showed lower than another group. B. The elevated laboratory values showed in worse outcome patients.
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