COVID-19 Pandemic Research Opportunities in India: What the Pandemic Is Teaching Us About Transplantation

Coronavirus disease (COVID-19) has engulfed the whole world, and India has been the second worst-hit nation. Organ transplant services were halted in both the public and private care sectors of India, with public care sectors more adversely affected. Deceased donations were disproportionately more affected, with unfavorable rates at the peak of the pandemic. Mortality outcomes of COVID-19 among different organ transplant recipients in India have been lower compared with the Western world, with younger age and less comorbidities among Indian populations partly responsible for the lower mortality. Mortality and graft loss were mostly associated with older age and those with chronic graft dysfunction. During the pandemic, invasive fungal infections, like mucormycosis, have been reported, illustrating the need for multidisciplinary management. The Indian transplant societies have formulated and timely revised guidelines for transplantation in the COVID-19 era. Living donor transplants (both liver and kidney) after recovery from COVID-19 were both first described in India, providing a guiding tool for the world. Follow-up reports of recovered solid-organ transplant recipients have also been reported in Indian studies, showing reassuring long-term outcomes. Data of breakthrough COVID-19 cases after vaccination among both transplant recipients and waitlist candidates and research in vaccine efficacy for solid- organ transplant recipients is still underway. We suggest continuing and intensifying research activities for a better plan and strategy in case of a future pandemic.

Automated summary

COVID-19 mortality among organ transplant recipients in India is lower compared with the Western world, attributed to younger age and fewer comorbidities among the Indian population. Older age and chronic graft dysfunction are associated with higher mortality and graft loss. Indian transplant societies have formulated guidelines for transplantation during the COVID-19 era and living donor transplants after recovery from COVID-19 were first described in India. Reports of recovered solid-organ transplant recipients show reassuring long-term outcomes.