Revista do Instituto de Medicina Tropical de São Paulo (Feb 2022)

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

  • 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

DOI
https://doi.org/10.1590/s1678-9946202264008
Journal volume & issue
Vol. 64

Abstract

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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.

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