Impact of COVID-19 on liver transplant recipients during the first pandemic wave, in a tertiary hospital, in Northeastern Brazil

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Marina Seixas Studart e Neves, José Hícaro Hellano Gonçalves Lima Paiva, Natália Stefani de Assunção Ferreira, Francisca Patrícia Almeida Queiroz, Camilla Bezerra Bastos Limeira, Camila Monteiro Veras, Themístocles Mesquita Teles de Carvalho, Taina Veras de Sandes Freitas, Ronaldo de Matos Esmeraldo, Ivelise Regina Canito Brasil
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2022
• Subjects: Coronavirus infections; Liver transplantation; COVID-19; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946202264008; https://doaj.org/article/efd6feb53cfd4670bb291ca270f3e9b4

ABSTRACT Worldwide, transplant programs have suffered a setback during the coronavirus disease 2019 (COVID-19) pandemic and most have temporarily suspended their transplant activities. . We identified 36 liver transplant patients who tested positive for COVID-19. The cases were confirmed by the nucleic acid test (RT-PCR). Epidemiological, demographic, clinical, laboratory, management and outcome data were obtained from the patients’ medical records. Fourteen patients (38.9%) required admission to the Intensive Care Unit and/or invasive ventilatory support (severe cases). The mean age of these severe cases was 63.8 years. Regarding the time since the transplant, 71.4% (10/14 patients) had undergone the procedure less than one year before. The immunosuppressive therapy was reduced in patients who required Intensive Care Unit. A total of 12 cases (12/14, 85.7%) required invasive ventilatory support. Eight cases (8/14, 57.1%) required renal replacement therapy. In this group of patients, nine died (64.3 %). In turn, 22 patients had mild to moderate symptoms of COVID-19, not requiring invasive ventilatory support or admission to the Intensive Care Unit. The mean age in these patients was 56.5 years and comorbidities were present in 15 (68.2%) of the cases. In this group, only five patients (5/22, 22.7%) required hospitalization due to complications and there were no deaths This report describes the results of COVID-19 infection in a very specific population, suggesting that liver transplant patients have a significant higher risk of progressing to severeCOVID-19 , with a mortality rate among critically-ill patients above that of the general population.