TY - JOUR
T1 - COVID-19 in an international European liver transplant recipient cohort
AU - Becchetti, Chiara
AU - Zambelli, Marco Fabrizio
AU - Pasulo, Luisa
AU - Donato, Maria Francesca
AU - Invernizzi, Federica
AU - Detry, Olivier
AU - Dahlqvist, Géraldine
AU - Ciccarelli, Olga
AU - Morelli, Maria Cristina
AU - Fraga, Montserrat
AU - Svegliati-Baroni, Gianluca
AU - van Vlierberghe, Hans
AU - Coenraad, Minneke J.
AU - Romero, Mario Cristobal
AU - de Gottardi, Andrea
AU - Toniutto, Pierluigi
AU - Del Prete, Luca
AU - Abbati, Claudia
AU - Samuel, Didier
AU - Pirenne, Jacques
AU - Nevens, Frederik
AU - Dufour, Jean François
AU - Colledan, Michele
AU - Fagiuoli, Stefano
AU - Camagni, Stefania
AU - Delwaide, Jean
AU - Vitale, Giovanni
AU - Moradpour, Darius
AU - Pascual, Manuel
AU - Allegrini, Gloria
AU - Tarsetti, Fabio
AU - Giustizieri, Ugo
AU - Rota, Loredana
AU - Artru, Florent
AU - Saouli, Anne Catherine
AU - Burra, Patrizia
AU - Gambato, Martina
AU - Scalera, Irene
AU - Petridis, Ioannis
AU - Marques, Hugo Pinto
AU - Welker, Martin Walter
N1 - Funding Information:
This study was funded by Stiftung für die Leberkrankheiten (Switzerland).
Publisher Copyright:
© 2020 BMJ Publishing Group. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
KW - chronic liver disease
KW - infectious disease
KW - orthotopic liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=85087570244&partnerID=8YFLogxK
U2 - 10.1136/gutjnl-2020-321923
DO - 10.1136/gutjnl-2020-321923
M3 - Article
C2 - 32571972
AN - SCOPUS:85087570244
SN - 0017-5749
VL - 69
SP - 1832
EP - 1840
JO - Gut
JF - Gut
IS - 10
ER -