Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review

Abstract Background The COVID-19 pandemic has devastated the global community with nearly 4.9 million deaths as of October 2021. While organ transplant (OT) recipients (OTr) may be at increased risk for severe COVID-19 due to their chronic immunocompromised state, outcomes for OTr with COVID-19 rema...

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Autores principales:	Alexis H. Lerner, Elizabeth J. Klein, Anna Hardesty, Orestis A. Panagiotou, Chelsea Misquith, Dimitrios Farmakiotis
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 Organ transplant Immunosuppression Medicine R
Acceso en línea:	https://doaj.org/article/61dd59b9f7404c29b1005ee6e6e1c30c
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spelling	oai:doaj.org-article:61dd59b9f7404c29b1005ee6e6e1c30c2021-11-28T12:06:35ZComparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review10.1186/s13643-021-01854-82046-4053https://doaj.org/article/61dd59b9f7404c29b1005ee6e6e1c30c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13643-021-01854-8https://doaj.org/toc/2046-4053Abstract Background The COVID-19 pandemic has devastated the global community with nearly 4.9 million deaths as of October 2021. While organ transplant (OT) recipients (OTr) may be at increased risk for severe COVID-19 due to their chronic immunocompromised state, outcomes for OTr with COVID-19 remain disputed in the literature. This review will examine whether OTr with COVID-19 are at higher risk for severe illness and death than non-immunocompromised individuals. Methods MEDLINE (via Ovid and PubMed) and EMBASE (via Embase.com ) will be searched from December 2019 to October 2021 for observational studies (including cohort and case-control) that compare COVID-19 clinical outcomes in OTr to those in individuals without history of OT. The primary outcome of interest will be mortality as defined in each study, with possible further analyses of in-hospital mortality, 28 or 30-day mortality, and all-cause mortality versus mortality attributable to COVID-19. The secondary outcome of interest will be the severity of COVID-19 disease, most frequently defined as requiring intensive care unit admission or mechanical ventilation. Two reviewers will independently screen all abstracts and full-text articles. Potential conflicts will be resolved by a third reviewer and potentially discussion among all investigators. Methodological quality will be appraised using the Newcastle-Ottawa Scale. If data permit, we will perform random-effects meta-analysis with the Sidik-Jonkman estimator and the Hartung-Knapp adjustment for confidence intervals to estimate a summary measure of association between histories of transplant with each outcome. Potential sources of heterogeneity will be explored using meta-regression. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., subgroup analysis) considering least minimal adjustment for confounders. Discussion This rapid review will assess the available evidence on whether OTr diagnosed with COVID-19 are at higher risk for severe illness and death compared to non-immunocompromised individuals. Such knowledge is clinically relevant and may impact risk stratification, allocation of organs and healthcare resources, and organ transplantation protocols during this, and future, pandemics. Systematic review registration Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/osf.io/4n9d7 .Alexis H. LernerElizabeth J. KleinAnna HardestyOrestis A. PanagiotouChelsea MisquithDimitrios FarmakiotisBMCarticleCOVID-19Organ transplantImmunosuppressionMedicineRENSystematic Reviews, Vol 10, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Organ transplant Immunosuppression Medicine R
spellingShingle	COVID-19 Organ transplant Immunosuppression Medicine R Alexis H. Lerner Elizabeth J. Klein Anna Hardesty Orestis A. Panagiotou Chelsea Misquith Dimitrios Farmakiotis Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
description	Abstract Background The COVID-19 pandemic has devastated the global community with nearly 4.9 million deaths as of October 2021. While organ transplant (OT) recipients (OTr) may be at increased risk for severe COVID-19 due to their chronic immunocompromised state, outcomes for OTr with COVID-19 remain disputed in the literature. This review will examine whether OTr with COVID-19 are at higher risk for severe illness and death than non-immunocompromised individuals. Methods MEDLINE (via Ovid and PubMed) and EMBASE (via Embase.com ) will be searched from December 2019 to October 2021 for observational studies (including cohort and case-control) that compare COVID-19 clinical outcomes in OTr to those in individuals without history of OT. The primary outcome of interest will be mortality as defined in each study, with possible further analyses of in-hospital mortality, 28 or 30-day mortality, and all-cause mortality versus mortality attributable to COVID-19. The secondary outcome of interest will be the severity of COVID-19 disease, most frequently defined as requiring intensive care unit admission or mechanical ventilation. Two reviewers will independently screen all abstracts and full-text articles. Potential conflicts will be resolved by a third reviewer and potentially discussion among all investigators. Methodological quality will be appraised using the Newcastle-Ottawa Scale. If data permit, we will perform random-effects meta-analysis with the Sidik-Jonkman estimator and the Hartung-Knapp adjustment for confidence intervals to estimate a summary measure of association between histories of transplant with each outcome. Potential sources of heterogeneity will be explored using meta-regression. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., subgroup analysis) considering least minimal adjustment for confounders. Discussion This rapid review will assess the available evidence on whether OTr diagnosed with COVID-19 are at higher risk for severe illness and death compared to non-immunocompromised individuals. Such knowledge is clinically relevant and may impact risk stratification, allocation of organs and healthcare resources, and organ transplantation protocols during this, and future, pandemics. Systematic review registration Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/osf.io/4n9d7 .
format	article
author	Alexis H. Lerner Elizabeth J. Klein Anna Hardesty Orestis A. Panagiotou Chelsea Misquith Dimitrios Farmakiotis
author_facet	Alexis H. Lerner Elizabeth J. Klein Anna Hardesty Orestis A. Panagiotou Chelsea Misquith Dimitrios Farmakiotis
author_sort	Alexis H. Lerner
title	Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
title_short	Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
title_full	Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
title_fullStr	Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
title_full_unstemmed	Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review
title_sort	comparison of covid-19 outcomes in organ transplant recipients (otr) and non-transplant patients: a study protocol for rapid review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/61dd59b9f7404c29b1005ee6e6e1c30c
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Comparison of COVID-19 outcomes in organ transplant recipients (OTr) and non-transplant patients: a study protocol for rapid review

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