tetano
Editor, Senior Moderator
Clin Res Hepatol Gastroenterol
. 2021 Jan 28;45(4):101639.
doi: 10.1016/j.clinre.2021.101639. Online ahead of print.
Covid-19 in liver transplant recipients: the French SOT COVID registry
J?r?me Dumortier[SUP] 1 [/SUP], Christophe Duvoux[SUP] 2 [/SUP], Olivier Roux[SUP] 3 [/SUP], Mario Altieri[SUP] 4 [/SUP], H?l?ne Barraud[SUP] 5 [/SUP], Camille Besch[SUP] 6 [/SUP], Sophie Caillard[SUP] 7 [/SUP], Audrey Coilly[SUP] 8 [/SUP], Filomena Conti[SUP] 9 [/SUP], S?bastien Dharancy[SUP] 10 [/SUP], Fran?ois Durand[SUP] 3 [/SUP], Claire Francoz[SUP] 3 [/SUP], Florentine Garaix[SUP] 11 [/SUP], Pauline Houssel-Debry[SUP] 12 [/SUP], Ilias Kounis[SUP] 8 [/SUP], Guillaume Lassailly[SUP] 10 [/SUP], No?mie Laverdure[SUP] 13 [/SUP], Vincent Leroy[SUP] 2 [/SUP], Maxime Mallet[SUP] 9 [/SUP], Alessandra Mazzola[SUP] 9 [/SUP], Lucy Meunier[SUP] 14 [/SUP], Sylvie Radenne[SUP] 15 [/SUP], Jean-Philippe Richardet[SUP] 2 [/SUP], Claire Vanlemmens[SUP] 16 [/SUP], Marc Hazzan[SUP] 17 [/SUP], Faouzi Saliba[SUP] 8 [/SUP], French Solid Organ Transplant COVID Registry; Groupe de Recherche Fran?ais en Greffe de Foie (GReF?)
Affiliations
Abstract
Background: Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in organ transplant recipients remains limited. The aim of this registry-based observational study was to report the characteristics and clinical outcomes of liver transplant (LT) recipients included in the French nationwide Registry of Solid Organ Transplant Recipients with Covid-19.
Methods: COVID-19 was diagnosed in patients who had a positive PCR assay for SARS-CoV-2 or in presence of typical lung lesions on imaging or specific SARS-CoV-2 antibodies. Clinical and laboratory characteristics, management of immunosuppression, treatment for Covid-19, and clinical outcomes (hospitalization, admission to intensive care unit, mechanical ventilation, or death) were recorded.
Results: Of the 104 patients, 67 were admitted to hospital and 37 were managed at home (including all 13 children). Hospitalized patients had a median age of 65.2 years (IQR: 58.1 - 73.2 years) and two thirds were men. Most common comorbidities included overweight (67.3%), hypertension (61.2%), diabetes (50.7%), cardiovascular disease (20.9%) and respiratory disease (16.4%). SARS-CoV-2 infection was identified after a median of 92.8 months (IQR: 40.1 - 194.7 months) from LT. During hospitalization, antimetabolites, mTOR inhibitor, and CNIs were withdrawn in 41.9%, 30.0% and 12.5% of patients, respectively. The composite endpoint of severe Covid-19 within 30 days after diagnosis was reached by 33.0% of the adult patients. The 30-day mortality rate was 20.0%, and 28.1% for hospitalized patients. Multivariate analysis identified that age was independently associated with mortality.
Conclusion: In our large nationwide study, Covid-19 in LT recipients was associated with a high mortality rate.
Keywords: Covid-19; Immunosuppression; Liver transplantation; Mortality; Prognosis.
. 2021 Jan 28;45(4):101639.
doi: 10.1016/j.clinre.2021.101639. Online ahead of print.
Covid-19 in liver transplant recipients: the French SOT COVID registry
J?r?me Dumortier[SUP] 1 [/SUP], Christophe Duvoux[SUP] 2 [/SUP], Olivier Roux[SUP] 3 [/SUP], Mario Altieri[SUP] 4 [/SUP], H?l?ne Barraud[SUP] 5 [/SUP], Camille Besch[SUP] 6 [/SUP], Sophie Caillard[SUP] 7 [/SUP], Audrey Coilly[SUP] 8 [/SUP], Filomena Conti[SUP] 9 [/SUP], S?bastien Dharancy[SUP] 10 [/SUP], Fran?ois Durand[SUP] 3 [/SUP], Claire Francoz[SUP] 3 [/SUP], Florentine Garaix[SUP] 11 [/SUP], Pauline Houssel-Debry[SUP] 12 [/SUP], Ilias Kounis[SUP] 8 [/SUP], Guillaume Lassailly[SUP] 10 [/SUP], No?mie Laverdure[SUP] 13 [/SUP], Vincent Leroy[SUP] 2 [/SUP], Maxime Mallet[SUP] 9 [/SUP], Alessandra Mazzola[SUP] 9 [/SUP], Lucy Meunier[SUP] 14 [/SUP], Sylvie Radenne[SUP] 15 [/SUP], Jean-Philippe Richardet[SUP] 2 [/SUP], Claire Vanlemmens[SUP] 16 [/SUP], Marc Hazzan[SUP] 17 [/SUP], Faouzi Saliba[SUP] 8 [/SUP], French Solid Organ Transplant COVID Registry; Groupe de Recherche Fran?ais en Greffe de Foie (GReF?)
Affiliations
- PMID: 33636654
- PMCID: PMC7843027
- DOI: 10.1016/j.clinre.2021.101639
Abstract
Background: Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in organ transplant recipients remains limited. The aim of this registry-based observational study was to report the characteristics and clinical outcomes of liver transplant (LT) recipients included in the French nationwide Registry of Solid Organ Transplant Recipients with Covid-19.
Methods: COVID-19 was diagnosed in patients who had a positive PCR assay for SARS-CoV-2 or in presence of typical lung lesions on imaging or specific SARS-CoV-2 antibodies. Clinical and laboratory characteristics, management of immunosuppression, treatment for Covid-19, and clinical outcomes (hospitalization, admission to intensive care unit, mechanical ventilation, or death) were recorded.
Results: Of the 104 patients, 67 were admitted to hospital and 37 were managed at home (including all 13 children). Hospitalized patients had a median age of 65.2 years (IQR: 58.1 - 73.2 years) and two thirds were men. Most common comorbidities included overweight (67.3%), hypertension (61.2%), diabetes (50.7%), cardiovascular disease (20.9%) and respiratory disease (16.4%). SARS-CoV-2 infection was identified after a median of 92.8 months (IQR: 40.1 - 194.7 months) from LT. During hospitalization, antimetabolites, mTOR inhibitor, and CNIs were withdrawn in 41.9%, 30.0% and 12.5% of patients, respectively. The composite endpoint of severe Covid-19 within 30 days after diagnosis was reached by 33.0% of the adult patients. The 30-day mortality rate was 20.0%, and 28.1% for hospitalized patients. Multivariate analysis identified that age was independently associated with mortality.
Conclusion: In our large nationwide study, Covid-19 in LT recipients was associated with a high mortality rate.
Keywords: Covid-19; Immunosuppression; Liver transplantation; Mortality; Prognosis.