Covid-19 in liver transplant recipients: the French SOT COVID registry

Dumortier, Jérôme; Duvoux, Christophe; Roux, Olivier; Altieri, Mario; Barraud, Hélène; Besch, Camille; Caillard, Sophie; Coilly, Audrey; Conti, Filoména; Dharancy, Sébastien; Durand, François; Francoz, Claire; Garaix, Florentine; Houssel‐Debry, Pauline; Kounis, Ilias; Lassailly, Guillaume; Laverdure, Noémie; Leroy, Vincent; Mallet, Maxime; Mazzola, Alessandra; Meunier, Lucy; Radenne, Sylvie; Richardet, Jean Philippe; Vanlemmens, Claire; Hazzan, Marc; Saliba, Faouzi

doi:10.1016/j.clinre.2021.101639

Cited by 47 publications

(89 citation statements)

References 32 publications

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“…Three articles reported angiotensin-converting enzyme inhibitor (ACEi) use in 27% (70/259) of patients. [17,22,37] Obesity was reported in seven articles, and 23¢6% (158/670) of LT recipients were obese (BMI > 30 kg/m 2 ) [17,23,24,26,29,30,36]. Table 1 describes the baseline demographics of the included patients.…”

Section: Characteristics Of Liver Transplant Recipients and Controlsmentioning

confidence: 99%

Impact of COVID-19 on liver transplant recipients–A systematic review and meta-analysis

et al. 2021

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Background: Immunosuppression and comorbidities increase the risk of severe coronavirus disease-2019 in solid organ transplant (SOT) recipients. The outcomes of COVID-19 in liver transplant (LT) recipients remain unclear. We aimed to analyse the outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in LT recipients. Methods: The electronic databases were searched for articles published from 1 December 2019 to 20 May 2021 with MeSH terms COVID-19, SARS-CoV-2, and liver transplantation. Studies reporting outcomes in more than 10 LT recipients were included for analysis. LT vs non-LT patients with COVID-19 infection were compared for all-cause mortality, which was the primary outcome studied. We also evaluated the relation between the timing of COVID-19 infection post-LT (< one year vs > one year) and mortality. Findings: Eighteen articles reporting 1,522 COVID-19 infected LT recipients were included for the systematic review. The mean age (standard deviation [SD]) was 60¢38 (5¢24) years, and 68¢5% were men. The mean time (SD) to COVID-19 infection was 5¢72 (1¢75) years. Based on 17 studies (I 2 = 7¢34) among 1,481 LT recipients, the cumulative incidence of mortality was 17¢4% (95% confidence interval [CI], 15¢4À19¢6). Mortality was comparable between LT (n = 610) and non-LT (n = 239,704) patients, based on four studies (odds ratio [OR], 0¢8 [0¢6À1¢08]; P = 0¢14). Additionally, there was no significant difference in mortality between those infected within one year vs after one year of LT (OR, 1¢5 [0¢63À3¢56]; P = 0¢35). The cumulative incidence of graft dysfunction was 2¢3% (1¢3À4¢1). Nearly 23% (20¢71À25) of the LT patients developed severe COVID-19 infection. Before infection, 71% and 49% of patients were on tacrolimus and mycophenolate mofetil, respectively. Immunosuppression was modified in 55¢9% (38¢1À72¢2) patients after COVID-19 infection. Interpretation: LT and non-LT patients with COVID-19 have a similar risk of adverse outcomes.

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Section: Characteristics Of Liver Transplant Recipients and Controlsmentioning

confidence: 99%

Impact of COVID-19 on liver transplant recipients–A systematic review and meta-analysis

et al. 2021

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“…After excluding age, diabetes and chronic kidney disease significantly associated with mortality Polak 4 244 36 (14.7%) died, internet based survey Webb 34 39 Data from registry, 9 (23%) died, 4 of death happened in patients transplanted < 2 years back, 4 of died had diabetes and hypertension, 3 were obese Rabiee 35 112 25 (22.3%) died, LT recipients had lower acute liver injury when compared to age and sex matched CLD, reduction of immunosuppression was not associated with liver injury/mortality. ALI significantly associated with mortality Lee 36 38 7 died (18% overall, 29% of hospitalized) Dumortier 37 104 20 died, age independently associated with mortality Becchetti 38 57 7 died (12%), 5 of 7 mortalities happened in cases with history of cancers Colmenero 39 111 31.5% had severe disease, 20 (18%) mortality Webb 40 151 28 (19%) died, when compared to matched non-transplant population, mortality was not high in transplant recipients Dhampalwar 41 12 1 died Case reports or small series 32 , 42 , 43 , 44 , 45 , 46 27 9 died Total 1138 211 died (18.5%) …”

Section: Introductionmentioning

confidence: 98%

“…In a model excluding age, both diabetes and chronic kidney disease were significantly associated with mortality. 37 …”

Section: Introductionmentioning

confidence: 99%

Outcomes of COVID-19 in Patients with Cirrhosis or Liver Transplantation

Choudhary

Dhampalwar

Saraf

et al. 2021

Journal of Clinical and Experimental Hepatology

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Coronavirus disease 2019 (COVID-19) is associated with a significant morbidity and mortality in patients with cirrhosis. There is a significantly higher morbidity and mortality due to COVID-19 in patients with decompensated cirrhosis as compared to compensated cirrhosis, and in patients with cirrhosis as compared to non-cirrhotic chronic liver disease. The fear of COVID-19 before or after liver transplantation has lead to a significant reduction in liver transplantation numbers, and patients with decompensated cirrhosis remain at risk of wait list mortality. The studies in liver transplantation recipients show that risk of mortality due to COVID-19 is generally driven by higher age and comorbidities. The current review discusses available literature regarding outcomes of COVID-19 in patients with cirrhosis and outcomes in liver transplant recipients.

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“…As older age and cardiovascular disease are major factors associated with increased disease severity and mortality of COVID-19 [127,128], many ATTR amyloidosis patients are at increased risk of disease aggravation when they are infected with SARS-CoV-2. ATTRv amyloidosis patients who have undergone liver transplantation and receive immunosuppressive agents may also have a risk of higher mortality, although the association between liver transplantation and COVID-19 is still under debate [129][130][131]. From this viewpoint, close interspecialty communication to determine the optimal interval of evaluation is needed for the management of patients with ATTR amyloidosis.…”

Section: Discussionmentioning

confidence: 99%