Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic

Merli, Marco; Lauterio, Andrea; Prosperi, M.; Travi, Giovanna; Roselli, Elena; Petrò, Laura; Carlis, Luciano De; Belli, Luca; Puoti, Massimo

doi:10.1002/lt.25806

Cited by 13 publications

(13 citation statements)

References 4 publications

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“…However, the authors referred to an association between the post-LT time and the outcome: they reported that of five patients who had LT within one month, four died. Another point of view is presented by Belli et al 61 and by Bhoori et al 16 in their correspondence, and by Merli et al 62 in their letter to the editor. All concluded that mortality could be worse in patients with longer LT time.…”

Section: Discussionmentioning

confidence: 94%

Covid-19 Impact on Liver Transplantation Recipients

Carmo

Marques

Diogo

2021

BJT

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What was considered to be a "viral pneumonia" in Wuhan, China, evolved to a PHEIC, and on March 11, 2020, it was considered a pandemic by the WHO.¹ The etiological agent responsible was identified as severe acute respiratory syndrome coronavirus,² responsible for coronavirus infectious disease . Until October 7, 2020, there have been reported above 76 million COVID-19 cases, and above 1,7 million deaths in 235 countries, areas or territories.²

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Section: Discussionmentioning

confidence: 94%

Covid-19 Impact on Liver Transplantation Recipients

Carmo

Marques

Diogo

2021

BJT

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“…There have been several observational and register studies on SARS-CoV-2 infections in adult LT recipients. In general, adult LT recipients showed comparable courses of COVID-19 to nontransplant patients (88,89). However, the severity and course of COVID-19 infections are mainly determined by extrahepatic comorbidities.…”

Section: Covid-19 In Pediatric Liver Transplant Recipientsmentioning

confidence: 89%

COVID-19 in Children With Liver Disease

et al. 2021

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Background: The global pandemic caused by novel Coronavirus SARS-CoV-2 disease (COVID-19) is a major threat to the general population and for patients with pre-existing chronic conditions. We report data concerning SARS-CoV-2 infection in children with chronic liver disease (CLD).Methods: A literature review using the online database PubMed was performed to summarize available findings on the association between pre-existing liver disease and COVID-19 infection in children.Results: Children with COVID-19 have preserved effector and immunosuppressive components resulting in a milder disease compared to adults. The most common hepatic manifestation is an elevation of hepatic transaminases. Liver damage may be directly caused by viral infection of liver cells, by medications or by the chronic hypoxia seen in COVID-19 patients. A multicenter study reported that the majority of children with a CLD remained healthy during the outbreak. Similarly, studies reported that children on immunosuppressive treatment, including patients with autoimmune liver disease (AILD) and liver transplantation (LT), maintained good health during the outbreak without experiencing major complications even if infected with COVID-19.Conclusion: COVID-19-related liver injury presents with a mild elevation of transaminases, although its clinical significance is unclear. Children with CLD, including those with AILD and post-LT, do not have an increased risk for severe disease course of SARS-CoV-2 infection with little or no liver dysfunction. These data highlight the necessity to ensure normal standards of care while adhering to national Covid-19 guidelines, and particularly to maintain immunosuppressive medication to prevent relapse or rejection. Further research is required to evaluate the differences in clinical course between immunosuppressed adults and children and in particular whether asymptomatic infection is a concern.

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“…First, tumor patients were highly exposed to the risk of virus infection, because they require more hospitalization or outpatient visits. Also, the immune homeostasis of the tumor patients was blunted (16,17), especially those receiving chemotherapy, immunosuppressive therapy or molecular-targeted drug therapy, even those newly diagnosed patients have not been subjected to treatment or patients with best supportive care, their immune status were compromised (18).…”

Section: Discussionmentioning

confidence: 99%

“…The mortality rate was lower in the non-cancer group compared to the cancer group (4.50 vs. 9.03%; P < 0.001). The duration between onset and admission shorter in the cancer group (Days,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)) compared to the non-cancer group (Days, 10; [IQR 6-19]; P = 0.036). ICU occupancy was higher in the cancer group (n[%], 30[10.83%]) than in the non-cancer group (n[%], 314[4.11%]).…”

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confidence: 99%

Clinical Characteristics of Cancer Patients With COVID-19: A Retrospective Multicentric Study in 19 Hospitals Within Hubei, China

et al. 2021

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Objective: This study aimed to determine the association between prognosis of COVID-19 patients with and without cancer. Moreover, we compared the prognosis of cancer patients subjected to anti-tumor therapy with those who have not undergone anti-tumor therapy in the past 6 months.Methods and Results: A total of 7,926 adult patients with COVID-19 were retrospectively enrolled in Hubei Province,China between December 31, 2019 and February 20, 2020. Two hundred and seventy seven cancer patients (cancer group, median age 64 [IQR 56–70] years; 50.90% male) and 7,649 non-cancer patients were identified (non-cancer group, median age 55 [IQR 42–64] years; 48.19% male). The mortality rate was lower in the non-cancer group compared to the cancer group (4.50 vs. 9.03%; P < 0.001). The duration between onset and admission shorter in the cancer group (Days, 9 [IQR 5–18]) compared to the non-cancer group (Days, 10; [IQR 6–19]; P = 0.036). ICU occupancy was higher in the cancer group (n[%], 30[10.83%]) than in the non-cancer group (n[%], 314[4.11%]). In reviewing the anti-tumor therapy, data from 277 selected cancer patients were obtained out of which 74 patients had undergone anti-tumor therapy (mean age 65 [IQR 51–67] years; 45.95% male), 203 had not undergone anti-tumor therapy (non-anti-tumor therapy group, mean age 63 [IQR 53–75] years; 49.75% male) in the past 6 months. The mortality rate for the anti-tumor therapy group and the non-anti-tumor therapy group was similar (9.46 vs. 8.87%; P = 0.879).Conclusion: The mortality rate was higher in COVID-19 patients with cancer compared to those without cancer. Moreover, anti-tumor therapy in the past 6 months did not worsen the prognosis of cancer patients with COVID-19.

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Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic

Cited by 13 publications

References 4 publications

Covid-19 Impact on Liver Transplantation Recipients

Covid-19 Impact on Liver Transplantation Recipients

COVID-19 in Children With Liver Disease

Clinical Characteristics of Cancer Patients With COVID-19: A Retrospective Multicentric Study in 19 Hospitals Within Hubei, China

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