COVID-19–Associated Hepatitis Complicating Recent Living Donor Liver Transplantation

Lagana, Stephen M.; Michele, Simona De; Lee, Michael J.; Emond, Jean C.; Griesemer, Adam; Tulin-Silver, Sheryl; Verna, Elizabeth C.; Martínez, Mercedes; Lefkowitch, Jay H.

doi:10.5858/arpa.2020-0186-sa

Cited by 66 publications

(84 citation statements)

References 9 publications

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“…The characteristics of included trials were presented in Table 1 . A total of 269 patients from 47 studies [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 [95% CI, 42.49; 59.34], and 49% [95% CI, 0.33, 0.65] patients were female.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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Background The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality ( r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality ( r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.

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Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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“…Seven did not require hospitalization, and mortality affected 21% of the patients. There are 3 recent cases reported from the United States, [10][11][12] with good outcome.…”

Section: Discussionmentioning

confidence: 99%

“…There is a report of a LT recipient with perioperative infection, 3 two cases during follow-up in China, 4,5 3 cases from Lombardy, 6 6 cases from Madrid, 7 9 from an International Registry, 8 24 from a survey in Italy, 9 and 3 more in the United States. [10][11][12] Therefore, we aimed at presenting our preliminary experience involving COVID-19 in the LT population during the first 2 months of this pandemic crisis in Madrid.…”

mentioning

confidence: 99%

Varied clinical presentation and outcome of SARS‐CoV‐2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain

Loinaz

Marcacuzco

Fernández‐Ruiz

et al. 2020

Transplant Infectious Dis

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The first case of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, now termed as coronavirus disease 2019 (COVID-19), was diagnosed in Madrid on February 25, 2020. Within a few weeks, the infection spread extraordinarily. By the first week of March, some surgical procedures were already cancelled in our institution in anticipation of the lack of beds to admit patients with the infection. Actually, our last liver transplant (LT) procedure was performed on March 7th and the abdominal transplants program

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“…There is still limited knowledge about the course of in liver transplant recipients, especially in the case of early post-LT infection. 4,5 Recent series from USA 6 and Spain 7 have suggested that recipients of solid organ transplant affected by COVID-19 may present higher mortality as compared to the general population.…”

Section: Introductionmentioning

confidence: 99%

Outcome of COVID‐19 in liver transplant recipients: A preliminary report from Northwestern Italy

Patrono

Lupo

Canta³

et al. 2020

Transplant Infectious Dis

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Covid-19 pandemic is deeply affecting transplant activity worldwide. It is unclear whether solid organ transplant recipients are at increased risk of developing severe complications and how they should be managed, also concerning immunosuppression. This is a report about the course and management of SARS-CoV-2 infection in liver transplant recipients from a single center in Northwestern Italy in the period March-April 2020. Three patients who were treated at our institution are reported in detail, whereas summary data are provided for those managed at peripheral Hospitals. Presentation varied from asymptomatic to rapidly progressive respiratory failure due to bilateral interstitial pneumonia. Accordingly, treatment and changes to immunosuppression were adapted to the severity of the disease. Overall mortality was 20%, whereas Covid-related mortality was 10%. Two cases of prolonged (>2 months) viral carriage were observed in two asymptomatic patients who contracted the infection in the early course after transplant. Besides depicting Covid-19 course and possible treatment scenarios in liver transplant patients, these cases are discussed in relation to the changes in our practice prompted by Covid-19 epidemic, with potential implications for other transplant programs.

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COVID-19–Associated Hepatitis Complicating Recent Living Donor Liver Transplantation

Cited by 66 publications

References 9 publications

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Varied clinical presentation and outcome of SARS‐CoV‐2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain

Outcome of COVID‐19 in liver transplant recipients: A preliminary report from Northwestern Italy

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