Outcomes of COVID-19 in hospitalized kidney and liver transplant recipients- a single-center experience

Ślusarczyk, Aleksander; Tracz, Adam; Gronkiewicz, Magdalena; Jureczko, Lidia; Bączkowska, Teresa

doi:10.20452/pamw.16070

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…However, in our cohort only kidney transplant recipients were admitted to ICU or died within 30‐days after first‐positive SARS‐CoV‐2 PCR test. This is in line with previous studies reporting that COVID‐19 in liver transplant recipients was less severe and had fewer adverse outcomes than in kidney transplant recipients 45–47 . The kidney transplant recipients in our cohort had a higher burden of comorbidity than liver transplant recipients, including diabetes and cardiovascular diseases which are known risk factors for ICU admission and death 48 .…”

Section: Discussionsupporting

confidence: 90%

“…This is in line with previous studies reporting that COVID-19 in liver transplant recipients was less severe and had fewer adverse outcomes than in kidney transplant recipients. [45][46][47] The kidney transplant recipients in our cohort had a higher burden of comorbidity than liver transplant recipients, including diabetes and cardiovascular diseases which are known risk factors for ICU admission and death. 48 The impact of comorbidities is supported by a study from Sweden, where 30-day all-cause mortality was 17% in liver transplant recipients and 9.3% in kidney transplant recipients, and in this study liver transplant recipients had a higher burden of comorbidities.…”

Section: Risk Factors For Hospital Admission After Infectionmentioning

confidence: 99%

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Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark

Hamm

Rezahosseini

Loft

et al. 2022

American Journal of Transplantation

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Coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 has been associated with a high risk of adverse outcomes in solid organ transplant (SOT) recipients in the pre‐vaccination era. In this retrospective cohort study, we examined the incidence and severity of COVID‐19 in kidney and liver transplant recipients in Denmark in the post‐vaccination era, from December 27, 2020, to December 27, 2021. We included 1428 SOT recipients with 143 cases of first‐positive SARS‐CoV‐2 PCR test. The cumulative incidence of first‐positive SARS‐CoV‐2 PCR test 1 year after initiation of vaccination was 10.4% (95% CI: 8.8–12.0), and the incidence was higher in kidney than in liver transplant recipients (11.6% [95% CI: 9.4–13.8] vs. 7.4% [95% CI: 5.1–9.8], p = .009). After the first‐positive SARS‐CoV‐2 PCR test, the hospitalization rate was 31.5% (95% CI: 23.9–39.1), and 30‐day all‐cause mortality was 3.7% (95% CI: 0.5–6.8). Hospitalization was lower in vaccinated than in unvaccinated SOT recipients (26.4% [95% CI: 18.1–34.6] vs. 48.5% [95% CI: 31.4–65.5], p = .011), as was mortality (1.8% [95% CI: 0.0–4.3] vs. 9.1% [95% CI: 0.0–18.9], p = .047). In conclusion, SOT recipients remain at high risk of adverse outcomes after SARS‐CoV‐2 infections, with a lower risk observed in vaccinated than in unvaccinated SOT recipients.

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Section: Discussionsupporting

confidence: 90%

Section: Risk Factors For Hospital Admission After Infectionmentioning

confidence: 99%

Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark

Hamm

Rezahosseini

Loft

et al. 2022

American Journal of Transplantation

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“…Concerning the epidemiology of COVID-19 in renal transplant patients, data are variable across the different countries based on the information available from nationwide registries and multicenter or local studies. The incidence of COVID-19 in kidney transplant recipients (KTR) per 1000 patients provided by European and US national registries ranges between 8.3% and 17.7% [ 4 ], but local single-center studies reported higher numbers [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Antibody Responses after Two Doses of COVID-19 mRNA Vaccine in Dialysis and Kidney Transplantation Patients Recovered from SARS-CoV-2 Infection

et al. 2022

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Background and Objectives: Hemodialysis patients (HD) and kidney transplant recipients (KTRs) have been heavily impacted by COVID-19, showing increased risk of infection, worse clinical outcomes, and higher mortality rates than the general population. Although mass vaccination remains the most successful measure in counteracting the pandemic, less evidence is available on vaccine effectiveness in immunodepressed subjects previously infected and recovered from COVID-19. Materials and Methods: This study aimed at investigating the ability to develop an adequate antibody response after vaccination in a 2-dose series against SARS-CoV-2 in HD patients and KTR that was administered after laboratory and clinical recovery from COVID-19. Results: Comparing SARS-CoV-2 S1/S2 IgG levels measured before and after 2 doses of mRNA vaccine (BNT162b2 vaccine, Comirnaty, Pfizer–BioNTech or mRNA-1273 vaccine, Spikevax, Moderna), highly significant increases of antibody titers were observed. The antibody peak level was reached at 3 months following second dose administration, regardless of the underlying cause of immune depression and the time of pre-vaccine serology assessment after negativization. Conclusions: Our data indicate that HD patients and KTR exhibit a satisfying antibody response to a 2-dose series of mRNA vaccine, even in cases when infection-induced humoral immunity was poor or rapidly fading. Further studies are needed to evaluate the role of booster doses in conferring effective and durable protection in weak patient categories.

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“…On average, patients in each group spent more than 1 week in the hospital according to our study. Also, data on the need for supplemental oxygen among liver transplant recipients with COVID-19 are limited[ 15 ]. There is no comparison available to date for oxygen requirement among COVID-19 patients who have been liver transplant recipients’ compared to those who are not.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of coronavirus disease 2019 in liver transplant recipients

Shafiq¹,

Gibson²

2022

WJH

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BACKGROUND Liver transplant patients are at higher risk of infection due to immunosuppression. Whether liver transplant recipients are also more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and will have worse outcomes than the general population if they develop coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 is a topic of ongoing studies, including ours. AIM To assess the clinical outcomes of COVID-19 in liver transplant recipients. METHODS This was a case-control study, with a database search performed (at the study site) from March 1, 2020 through February 28, 2021. Patients 18 years or older who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) were included in the study. Patients with infection other than pneumonia at the time of admission were excluded. After selection, patients who had been the recipient of liver transplant were considered cases and those without as controls. After being matched by age, sex, and obesity, two controls were randomly selected for each case. Death and hospitalization due to COVID-19 infection were the primary outcomes. Secondary outcomes were pertinent only to patients who were hospitalized, and they included duration of hospital stay, need for supplemental oxygen, presence of at least one type of end-organ damage, effects on liver enzymes, incidence of acute liver failure, effect on d-dimer levels, and incidence of venous thromboembolism (VTE). Chi-square or Fisher’s exact test was used to compare all primary and secondary outcomes with the exception of duration of hospital stay and d-dimer levels, which were compared using the Wilcoxon signed-rank test. Alpha criterion was set at 0.05. Logistic regression was performed for each primary outcome (as the dependent variable). Statistical analyses were performed using R software. RESULTS Of the 470 Liver transplant recipients who were tested for COVID-19 via the PCR test, 39 patients tested positive (8.3%). There was no significant difference between cases and controls regarding death [odds ratio (OR): 2.04, 95% confidence interval (CI): 0.14–29.17; P = 0.60] and hospitalization rates (OR: 1.38, 95%CI: 0.59–3.24; P = 0.46). There also was no significant difference between cases and controls with respect to all secondary outcomes. Among all patients who had elevated liver enzymes, their levels were either normalized, improving, or remained stable at the time of discharge. No patient developed acute liver failure. Of the 31 hospitalized patients, 27 received a prophylactic anticoagulation dose and no patient developed VTE in either group. Among cases who were hospitalized, immunosuppression was decreased in 5 patients and there was no change in immunosuppression among the remaining 7 patients. One patient died in each of these two subgroups. Logistic regression analysis...

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Outcomes of COVID-19 in hospitalized kidney and liver transplant recipients- a single-center experience

Cited by 4 publications

References 29 publications

Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark

Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark

Antibody Responses after Two Doses of COVID-19 mRNA Vaccine in Dialysis and Kidney Transplantation Patients Recovered from SARS-CoV-2 Infection

Clinical outcomes of coronavirus disease 2019 in liver transplant recipients

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