COVID-19 in an international European liver transplant recipient cohort.

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; ... (2020). COVID-19 in an international European liver transplant recipient cohort. Gut, 69(10), pp. 1832-1840. BMJ Publishing Group 10.1136/gutjnl-2020-321923

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Becchetti, Chiara and Dufour, Jean-François

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0017-5749

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

11 Sep 2020 13:24

Last Modified:

11 Sep 2020 13:24

Publisher DOI:

10.1136/gutjnl-2020-321923

PubMed ID:

32571972

Uncontrolled Keywords:

chronic liver disease infectious disease orthotopic liver transplantation

BORIS DOI:

10.7892/boris.146472

URI:

https://boris.unibe.ch/id/eprint/146472

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