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COVID-19 in hospitalized liver transplant recipients: An early systematic review and meta-analysis.
Jayant, Kumar; Reccia, Isabella; Virdis, Francesco; Pyda, Jordan S; Bachul, Piotr J; di Sabato, Diego; Barth, Rolf N; Fung, John; Baker, Talia; Witkowski, Piotr.
  • Jayant K; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
  • Reccia I; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Virdis F; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Pyda JS; Trauma Surgery Department, Royal London Hospital, London, UK.
  • Bachul PJ; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
  • di Sabato D; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
  • Barth RN; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
  • Fung J; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
  • Baker T; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
  • Witkowski P; The Transplantation Institute, Department of Surgery, University of Chicago, Chicago, IL, USA.
Clin Transplant ; 35(4): e14246, 2021 04.
Article in English | MEDLINE | ID: covidwho-1069387
ABSTRACT
Adverse clinical outcomes related to SARS-CoV-2 infection among liver transplant (LTx) recipients remain undefined. We performed a meta-analysis to determine the pooled prevalence of outcomes among hospitalized LTx recipients with COVID-19. A database search of literature published between December 1, 2019, and November 20, 2020, was performed per PRISMA guidelines. Twelve studies comprising 517 hospitalized LTx recipients with COVID-19 were analyzed. Common presenting symptoms were fever (71%), cough (62%), dyspnea (48%), and diarrhea (28%). Approximately 77% (95% CI, 61%-93%) of LTx recipients had a history of liver cirrhosis. The most prevalent comorbidities were hypertension (55%), diabetes (45%), and cardiac disease (21%). In-hospital mortality was 20% (95% CI, 13%-28%) and rose to 41% (95% CI, 19%-63%) (P < 0.00) with ICU admission. Additional subgroup analysis demonstrated a higher mortality risk in the elderly (>60-65 years) (OR 4.26; 95% CI, 2.14-8.49). There was no correlation in respect to sex or time since transplant. In summary, LTx recipients with COVID-19 had a high prevalence of dyspnea and gastrointestinal symptoms. In-hospital mortality was comparable to non-transplant populations with similar comorbidities but appeared to be less than what is reported elsewhere for cirrhotic patients (26%-40%). Importantly, the observed high case fatality in the elderly could be due to age-associated comorbidities.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / Transplant Recipients / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Transplant Journal subject: Transplantation Year: 2021 Document Type: Article Affiliation country: Ctr.14246

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Liver Transplantation / Transplant Recipients / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Transplant Journal subject: Transplantation Year: 2021 Document Type: Article Affiliation country: Ctr.14246