A single‐center report of COVID‐19 disease course and management in liver transplanted pediatric patients

Yüksel, Muhammed; Aktürk, Hacer; Mizikoglu, Ozlem; Toroslu, Ertuğ; Arıkan, Çiğdem

doi:10.1111/petr.14061

Cited by 14 publications

(15 citation statements)

References 36 publications

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“…A recent metaanalysis of 15 anakinra trials in COVID-19 patients showed a beneficial effect on lowering mortality [107]. Some pediatric liver transplant recipients successfully received anakinra as a part of multi-drug therapy [108]. A study of KTRs showed no significant effect in terms of intensive care unit admission or respiratory secondary infections between anakinra-and tocilizumab-treated groups [109].…”

Section: Il-1 Receptor Antagonistsmentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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Since its outbreak in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an enormous rise in scientific response with an excess of COVID-19-related studies on the pathogenesis and potential therapeutic approaches. Solid organ transplant (SOT) recipients are a heterogeneous population with long-lasting immunosuppression as a joining element. Immunocompromised patients are a vulnerable population with a high risk of severe infections and an increased infection-related mortality rate. It was postulated that the hyperinflammatory state due to cytokine release syndrome during severe COVID-19 could be alleviated by immunosuppressive therapy in SOT patients. On the other hand, it was previously established that T cell-mediated immunity, which is significantly weakened in SOT recipients, is the main component of antiviral immune responses. In this paper, we present the current state of science on COVID-19 immunology in relation to solid organ transplantation with prospective therapeutic and vaccination strategies in this population.

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Section: Il-1 Receptor Antagonistsmentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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“…Sin et al [ 18 ] reported a high rate of acute liver injury during a COVID-19 infection and worse outcomes in patients infected in the early period after liver transplantation. In contrast, Yuksel et al [ 10 ] reported that being immunocompromised did not affect disease severity or survival. Despite immunosuppressive treatment, all patients developed antibodies against COVID-19 in their study.…”

Section: Discussionmentioning

confidence: 97%

“…Literature on the clinical features and outcomes of SARS-CoV-2 infection in children with chronic gastrointestinal and liver diseases has mainly focused on three diseases: CLD, liver transplantation recipients, and inflammatory bowel disease [ 8 9 10 11 ].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Antibodies in Children with Chronic Disease from a Pediatric Gastroenterology Outpatient Clinic

Kaya

Issi

Güven

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose At the beginning of the Coronavirus disease (COVID-19) epidemic, physicians paid close attention to children with chronic diseases to prevent transmission or a severe course of infection. We aimed to measure the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels in children with chronic gastrointestinal and liver diseases to analyze the risk factors for infection and its interaction with their primary disease. Methods This cross-sectional study analyzed SARS-CoV-2 antibody levels in patients with gastrointestinal and liver diseases (n=141) and in healthy children (n=48) between January and February 2021. Results During the pandemic, 10 patients (7%) and 1 child (2%) had confirmed COVID-19 infection ( p =0.2). The SARS-CoV-2 antibody test was positive in 36 patients (25.5%) and 11 children (22.9%) ( p =0.7). SARS-CoV-2 antibody positivity was found in 20.4%, 26.6%, 33.3%, and 33.3% of patients with chronic liver diseases, chronic gastrointestinal tract diseases, cystic fibrosis, and liver transplantation recipients, respectively ( p >0.05, patients vs. healthy children). Risk factors for SARS-CoV-2 antibody positivity were COVID-19-related symptoms (47.2% vs. 14.2%, p =0.00004) and close contact with SARS-CoV-2 polymerase chain reaction-positive patients (69.4% vs. 9%, p <0.00001). The use, number, and type of immunosuppressants and primary diagnosis were not associated with SARS-CoV-2 antibody positivity. The frequency of disease activation/flare was not significant in patients with (8.3%) or without (14.2%) antibody positivity ( p =0.35). Conclusion SARS-CoV-2 antibodies in children with chronic gastrointestinal and liver diseases are similar to that in healthy children. Close follow-up is important to understand the long-term effects of past COVID-19 infection in these children.

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“…So far, data from our study support the fact that immunosuppression, after the critical post-transplant period of 6 months appears not to be a risk factor for the worsening of COVID-19 in PLTR. If there is a beneficial effect of immunosuppression by modulation of the immune system, thus preventing progression to severe forms of the disease, as suggested by uncontrolled observational clinical studies [ 15 , 35 , 36 , 37 , 38 , 39 , 40 ], this should be confirmed soon with comparative and controlled studies. Some limitations of the present study should be noted.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center

et al. 2022

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Background: The COVID-19 infection has received the attention of the scientific community due to its respiratory manifestations and association with evolution to severe acute respiratory syndrome (SARS-CoV-2). There are few studies characterizing SARS-CoV-2 in pediatric immunocompromised patients, such as liver transplanted patients. The aim of this study was to analyze the outcomes of the largest cohort of pediatric liver transplant recipients (PLTR) from a single center in Brazil who were infected with COVID-19 during the pandemic. Methods: Cross-sectional study. Primary outcomes: COVID-19 severity. The Cox regression method was used to determine independent predictors associated with the outcomes. Patients were divided into two groups according to the severity of COVID-19 disease: moderate–severe COVID and asymptomatic–mild COVID. Results: Patients categorized as having moderate–severe COVID-19 were younger (12.6 months vs. 82.1 months, p = 0.03), had a higher prevalence of transplantation from a deceased donor (50% vs. 4.3%, p = 0.02), and had a higher prevalence of COVID infection within 6 months after liver transplantation (LT) (75% vs. 5.7%, p = 0.002). The independent predictor of COVID-19 severity identified in the multivariate analysis was COVID-19 infection <6 months after LT (HR = 0.001, 95% CI = 0.001–0.67, p = 0.03). Conclusion: The time interval of less than 6 months between COVID-19 infection and LT was the only predictor of disease severity in pediatric patients who underwent liver transplantation.

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A single‐center report of COVID‐19 disease course and management in liver transplanted pediatric patients

Cited by 14 publications

References 36 publications

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

SARS-CoV-2 Antibodies in Children with Chronic Disease from a Pediatric Gastroenterology Outpatient Clinic

Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center

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