COVID-19 in hospitalized liver transplant recipients: An early systematic review and meta-analysis.

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard,

Liver Transplantation* ; Transplant Recipients*; COVID-19/*epidemiology; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/surgery ; Female ; Hospitalization ; Humans ; Liver Neoplasms/surgery ; Male ; Middle Aged

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.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

J Clin Virol. 2020 Jun;127:104371. (PMID: 32315817)
Am J Transplant. 2020 Jul;20(7):1849-1858. (PMID: 32301155)
Hepatogastroenterology. 2005 Nov-Dec;52(66):1803-8. (PMID: 16334781)
BMC Med Res Methodol. 2005 Apr 20;5:13. (PMID: 15840177)
Gut. 2021 Mar;70(3):531-536. (PMID: 32660964)
Lancet Gastroenterol Hepatol. 2020 Aug;5(8):724-725. (PMID: 32505228)
Lancet Gastroenterol Hepatol. 2020 Nov;5(11):1008-1016. (PMID: 32866433)
BMJ. 2020 Mar 26;368:m1091. (PMID: 32217556)
J Hepatol. 2020 Sep;73(3):566-574. (PMID: 32298767)
Gut. 2020 Jun;69(6):1144-1145. (PMID: 32198152)
Lancet Respir Med. 2020 May;8(5):475-481. (PMID: 32105632)
Hepatology. 2020 Sep;72(3):1102-1108. (PMID: 32369624)
Am J Transplant. 2020 Jul;20(7):1907-1910. (PMID: 32277591)
Lancet Gastroenterol Hepatol. 2020 May;5(5):428-430. (PMID: 32145190)
Stat Med. 2002 Jun 15;21(11):1539-58. (PMID: 12111919)
Lancet Gastroenterol Hepatol. 2020 Nov;5(11):958-960. (PMID: 32956620)
Transplantation. 2020 Nov;104(11):2208-2214. (PMID: 32496357)
Transpl Infect Dis. 2020 Oct;22(5):e13372. (PMID: 32562561)
Emerg Microbes Infect. 2020 Dec;9(1):727-732. (PMID: 32196410)
J Hepatol. 2021 Jan;74(1):148-155. (PMID: 32750442)
J Hepatol. 2020 Nov;73(5):1063-1071. (PMID: 32526252)
J Hepatol. 2021 Mar;74(3):567-577. (PMID: 33035628)
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2131-2133.e1. (PMID: 32334081)
Lancet Gastroenterol Hepatol. 2020 Jun;5(6):529-530. (PMID: 32203680)
Gut. 2020 Oct;69(10):1832-1840. (PMID: 32571972)
JAMA. 2020 May 26;323(20):2052-2059. (PMID: 32320003)
Lancet. 2020 Mar 28;395(10229):1054-1062. (PMID: 32171076)
Mil Med Res. 2020 Feb 29;7(1):7. (PMID: 32111253)
JAMA. 2020 Apr 28;323(16):1612-1614. (PMID: 32191259)
Aging Male. 2020 Dec;23(5):1416-1424. (PMID: 32508193)
BMC Med Res Methodol. 2014 Dec 19;14:135. (PMID: 25524443)
J Hepatol. 2020 Nov;73(5):1231-1240. (PMID: 32553666)
Lancet Gastroenterol Hepatol. 2020 Jul;5(7):643-644. (PMID: 32339474)
J Infect Dis. 2000 Aug;182(2):526-33. (PMID: 10915084)
SN Compr Clin Med. 2020;2(8):1069-1076. (PMID: 32838147)
Cell. 2006 Mar 10;124(5):915-27. (PMID: 16530040)
Lancet Infect Dis. 2020 May;20(5):533-534. (PMID: 32087114)
Am J Transplant. 2020 Oct;20(10):2876-2882. (PMID: 32412159)
J Clin Transl Hepatol. 2020 Mar 28;8(1):13-17. (PMID: 32274341)
JAMA. 2000 Apr 19;283(15):2008-12. (PMID: 10789670)
Transpl Infect Dis. 2020 Oct;22(5):e13353. (PMID: 32500942)
Gastroenterology. 2020 Sep;159(3):1176-1178.e2. (PMID: 32442561)
Gut. 2021 Feb;70(2):433-436. (PMID: 32434831)
Int J Infect Dis. 2020 May;94:91-95. (PMID: 32173574)
Lancet Gastroenterol Hepatol. 2020 Jun;5(6):532-533. (PMID: 32278366)
Clin Transplant. 2021 Apr;35(4):e14246. (PMID: 33555058)
Medicine (Baltimore). 2020 Oct 2;99(40):e22439. (PMID: 33019426)
JAMA Intern Med. 2020 Jul 1;180(7):934-943. (PMID: 32167524)
J Hepatol. 2020 Sep;73(3):705-708. (PMID: 32446714)
Liver Int. 2020 Jun;40(6):1321-1326. (PMID: 32239591)
Lancet. 2020 Mar 28;395(10229):1033-1034. (PMID: 32192578)
Lancet. 2020 Feb 15;395(10223):507-513. (PMID: 32007143)
Clin Mol Hepatol. 2020 Oct;26(4):562-576. (PMID: 33053932)
Lancet. 2020 Apr 4;395(10230):1111. (PMID: 32220278)
Front Med (Lausanne). 2020 Sep 09;7:567199. (PMID: 33015111)
Lancet Diabetes Endocrinol. 2020 Oct;8(10):823-833. (PMID: 32798471)

Keywords: COVID-19; SARS-CoV-2; liver transplantation

Date Created: 20210208 Date Completed: 20210527 Latest Revision: 20221005

20240628

PMC7995098

10.1111/ctr.14246

33555058