COVID-19 in Liver Transplant Recipients: A Systematic Review

Becchetti, Chiara; Gschwend, Sarah Gabriela; Dufour, Jean‐François; Banz, Vanessa

doi:10.3390/jcm10174015

Cited by 20 publications

(22 citation statements)

References 79 publications

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“…The clinical presentation of COVID-19 in LT recipients does not seem dissimilar to that of patients with non-LT, with respiratory symptoms being the pivotal ones. However, several studies highlighted a higher rate of GI manifestations in this population than in patients with non-LT (30% vs 12%, respectively; p<0.0001),102 with rates of diarrhoea ranging from 22% to 30% among the former 103…”

Section: Covid-19 and Liver Transplantmentioning

confidence: 78%

COVID-19 and liver disease

Dufour

Marjot

Becchetti

et al. 2022

Gut

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Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review COVID-19 liver manifestations and pathophysiological aspects related to SARS-CoV-2 infection in patients without liver disease as well as the impact of COVID-19 in patients with chronic liver disease (CLD), particularly cirrhosis and liver transplantation (LT). SARS-CoV-2 infection has been associated with overt proinflammatory cytokine profile, which probably contributes substantially to the observed early and late liver abnormalities. CLD, particularly decompensated cirrhosis, should be regarded as a risk factor for severe COVID-19 and death. LT was impacted during the pandemic, mainly due to concerns regarding donation and infection in recipients. However, LT did not represent a risk factor per se of worse outcome. Even though scarce, data regarding COVID-19 specific therapy in special populations such as LT recipients seem promising. COVID-19 vaccine-induced immunity seems impaired in CLD and LT recipients, advocating for a revised schedule of vaccine administration in this population.

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Section: Covid-19 and Liver Transplantmentioning

confidence: 78%

COVID-19 and liver disease

Dufour

Marjot

Becchetti

et al. 2022

Gut

Self Cite

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“…In Campania region (Southern Italy) on the 16th of January 2021 the infection rate of SARS-CoV-2 and its case fatality rate have been of 5.39% and 3.15%, respectively 1 . In this scenario, the liver transplant population represents a priori a vulnerable cohort of patients at increased risk of infections and poor outcome due to chronic immunosuppression, high rates of comorbidities and advanced age 17 , 18 . Whether they are at particularly high risk for critical COVID-19 in real clinical practice still requires further evidence.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in liver transplant recipients: incidence, hospitalization and outcome in an Italian prospective double-centre study

Guarino

Cossiga

Loperto

et al. 2022

Sci Rep

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Liver transplant (LT) recipients are vulnerable to SARS-CoV-2-infection (COVID-19), due to immunosuppression and comorbidities. This study aimed to evaluate the impact of COVID-19 on LT recipients compared to general population in the Campania region. In this prospective double-centre study, we enrolled all consecutive adult LT recipients with confirmed SARS-CoV-2-infection. Data were collected at diagnosis of COVID-19 and during follow-up and compared with the regional population. Thirty LT recipients (3.28%) developed SARS-CoV-2-infection (76.66% male, median age 62.61 years). Sixteen (53.33%) were symptomatic. Common symptoms were fever, cough, fatigue, and anosmia. Twenty-five (83.33%) were outpatients, 5 (16.66%) required hospitalization (6.66% admitted to Intensive Care Unit, 6.62% developed Acute Respiratory Distress Syndrome and 6.66% died). Immunosuppressors were in 3 (10%) patients. Incidence rate of COVID-19 was similar between LT patients and general population (3.28% vs 4.37%, p = 0.142) with higher rate of symptoms in LT patients (53.33% vs 15.87%, p < 0.000). At univariate analysis, hospitalization and case fatality rates were higher in LT patients compared to general population (16.66% vs 4.54%, p = 0.001; and 6.66% vs 1.76%, p = 0.041, respectively). At multivariable logistic regression analysis, LT patients with COVID-19 were more frequently symptomatic (OR 5.447 [95% CI 2.437–12.177], p < 0.000), whereas hospitalization and death for COVID-19 were not significatively associated with LT condition (p = 0.724 and p = 0.462, respectively) and were comparable with general population. LT is not a risk factor for acquiring COVID-19. Nonetheless, LT patients are more frequently symptomatic, although comparable to the general population for hospitalization rate and mortality.

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“…The new coronavirus pathogen, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been identified as the cause of coronavirus disease 2019 (COVID-19) 1 . Preliminary reports indicated that in liver transplant (LT) recipients, the clinical outcome following COVID-19 was better compared to other solid organ transplant recipients 2 and not per se worse compared to the general population 3 . However, more recent reports indicate that mortality in LT recipients remains particularly elevated 4,5 .…”

Section: Introductionmentioning

confidence: 99%