COVID-19 in an international European liver transplant recipient cohort. Issue 10 (22nd June 2020)

• Record Type: Journal Article
• Authors: Becchetti, Chiara; Zambelli, Marco Fabrizio; Pasulo, Luisa; Donato, Maria Francesca; Invernizzi, Federica; Detry, Olivier; Dahlqvist, Géraldine; Ciccarelli, Olga; Morelli, Maria Cristina; Fraga, Montserrat; Svegliati-Baroni, Gianluca; van Vlierberghe, Hans; Coenraad, Minneke J; Romero, Mario Cristobal; de Gottardi, Andrea; Toniutto, Pierluigi; Del Prete, Luca; Abbati, Claudia; Samuel, Didier; Pirenne, Jacques; Nevens, Frederik; Dufour, Jean-François
• Other Names: author non-byline.; Colledan Michele author non-byline.; Fagiuoli Stefano author non-byline.; Camagni Stefania author non-byline.; Delwaide Jean author non-byline.; Vitale Giovanni author non-byline.; Moradpour Darius author non-byline.; Pascual Manuel author non-byline.; Allegrini Gloria author non-byline.; Tarsetti Fabio author non-byline.; Giustizieri Ugo author non-byline.; Rota Loredana author non-byline.; Artru Florent author non-byline.; Saouli Anne-Catherine author non-byline.; Burra Patrizia author non-byline.; Gambato Martina author non-byline.; Scalera Irene author non-byline.; Petridis Ioannis author non-byline.; Marques Hugo Pinto author non-byline.; Welker Martin-Walter author non-byline.
• Is Part Of: Gut. Volume 69:Issue 10(2020)
• Page Start: 1832
• Page End: 1840
• Publication Date: 2020-06-22
• Subjects: orthotopic liver transplantation -- chronic liver disease -- infectious disease; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2020-321923
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Objective: Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection. Design: We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected. Results: 57 patients were included (70% male, median (IQR) age at diagnosis 65 (57–70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer. Conclusion: In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.