The spreading of severe respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to pandemics of coronavirus disease 2019 (COVID-19). While the symptoms of COVID-19 in general population varies from mild to severe, which is characterized by hospitalization, oxygen supply with ventilation support and mortality, it has been shown that the symptoms of COVID-19 in solid organ transplant recipients are generally severer with higher mortality rate.
　　The impacts of COVID-19 on solid organ transplant are broad and involve the whole transplant program. The severity was depending on the local COVID-19 incidence rate and policies. Specifically, transplant candidates in the waiting list, recipients and living related donors are all affected. It is also advised that non-critical transplantation and donation should be deferred to avoid peri-operative mortality during pandemics era. The immunosuppressive agents prescribed to control transplant organ rejection have different immunological effects on COVID-19 viral infection. In the initial phase of infection, by suppressing humoral and T cells activities, the immunosuppressants could enhance viral replications and increase lower respiratory tract viral colonies, while in the later phase of infection, immunosuppressants could help to counteract over-whelm inflammatory responses, thus avoid cytokines storms.
　　The mandate of vaccination is suggested by most of the nation. Besides, personal protection equipment (PPE), isolation and monoclonal antibodies against spike protein all have been proved effectively in lowering incidence of COVID 19 infection. Once infected, depending on the severity of symptoms, patients might have to be hospitalized and receive antiviral therapies including remdesivir, molnupiravir, low dose dexamethasone and recovered patient immunoglobulin. Recent data showed that in Omicron era, solid organ transplant recipients contracted COVID-19 could be treated on outpatient clinic and still had favorable survival outcome when compared to patients not receiving antiviral therapies. It has also been illustrated that with the mandate of vaccination and proper nucleic acid screening, transplant program could be restored gradually. In conclusion, the influence of COVID-19 pandemics to the transplant program is widespread. However, with vaccination and development of antiviral therapies, transplant activities could be resumed with careful approaches.