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Current Respiratory Medicine Reviews

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ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

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Research Article

The Outcome of Critical-phase COVID-19 in Liver Transplant Recipients

Author(s): Mahnaz Mozdourian, Rozita Khodashahi* and Mohsen Aliakbarian

Volume 19, Issue 2, 2023

Published on: 07 April, 2023

Page: [106 - 112] Pages: 7

DOI: 10.2174/1573398X19666230314124411

Price: $65

Abstract

Background: Considering the importance of assessing solid organ transplants, infected individuals with coronavirus disease 2019 (COVID-19), and the lack of information in this regard, this descriptive study aimed to investigate the clinical features, immunosuppressive agents, and outcomes of liver transplant recipients in the critical phase of infection with COVID-19.

Methods: This descriptive cross-sectional study was conducted on 12 critically ill liver transplant recipients referred to Imam Reza and Montaseriyeh hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, within 2020-21. The required data, including demographic and clinical information, were gathered and recorded in a checklist, and the correlations between variables were assessed in SPSS software (version 24).

Results: Hypertension, diabetes, and chronic kidney disease were reported in 83.3% (n = 10), 58.3% (n = 7), and 41.6% (n = 5) of patients, respectively. The administration of Mycophenolic acid was correlated with conjunctivitis (r = -0.67; P = 0.02), weakness (r = 0.77; P = 0.006), and sore throat (r = -0.67; P = 0.02). Ground glass opacity was reported in all patients, which was along with consolidation in 90.9% of the cases, and acute pulmonary embolism was found in 36.3% of the subjects. Finally, 66.7% (n = 8) of patients passed away. Among immunosuppressive agents, only the use of Mycophenolic acid was correlated with the outcome (r = -0.77; P = 0.006).

Conclusion: Due to the high rate of mortality among liver transplant recipients in the critical phase of COVID-19, earlier and more aggressive treatment with antiviral and antibacterial agents should be performed in this group of patients.

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Graphical Abstract

[1]
Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis 2020; 71(15): 762-8.
[http://dx.doi.org/10.1093/cid/ciaa248] [PMID: 32161940]
[2]
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: Consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395(10229): 1033-4.
[http://dx.doi.org/10.1016/S0140-6736(20)30628-0] [PMID: 32192578]
[3]
Tanaka Y, Sato Y, Sasaki T. Suppression of coronavirus replication by cyclophilin inhibitors. Viruses 2013; 5(5): 1250-60.
[http://dx.doi.org/10.3390/v5051250] [PMID: 23698397]
[4]
Aliakbarian M, Khodashahi R, Akhavan Rezayat K, et al. Outcomes of Liver Transplantation from Deceased Donors with Coronavirus- Disease 2019 and Late Complications of Infection. Curr Respir Med Rev 2022; 18(1): 4-7.
[http://dx.doi.org/10.2174/1573398X17666211209153335]
[5]
Saeed GA, Gaba W, Shah A, et al. Correlation between chest CT severity scores and the clinical parameters of adult patients with COVID-19 pneumonia. Radiol Res Pract 2021; 2021: 6697677.
[http://dx.doi.org/10.1155/2021/6697677]
[6]
Zhu L, Gong N, Liu B, et al. Coronavirus disease 2019 pneumonia in immunosuppressed renal transplant recipients: A summary of 10 confirmed cases in Wuhan, China. Eur Urol 2020; 77(6): 748-54.
[http://dx.doi.org/10.1016/j.eururo.2020.03.039] [PMID: 32317180]
[7]
Akalin E, Azzi Y, Bartash R, et al. COVID-19 and kidney transplantation. N Engl J Med 2020; 382(25): 2475-7.
[http://dx.doi.org/10.1056/NEJMc2011117] [PMID: 32329975]
[8]
D’Antiga L. Coronaviruses and immunosuppressed patients: The facts during the third epidemic. Liver Transpl 2020; 26(6): 832-4.
[http://dx.doi.org/10.1002/lt.25756] [PMID: 32196933]
[9]
Colmenero J, Rodríguez-Perálvarez M, Salcedo M, et al. Epidemiological pattern, incidence, and outcomes of COVID-19 in liver transplant patients. J Hepatol 2021; 74(1): 148-55.
[http://dx.doi.org/10.1016/j.jhep.2020.07.040] [PMID: 32750442]
[10]
Pereira MR, Mohan S, Cohen DJ, et al. COVID-19 in solid organ transplant recipients: Initial report from the US epicenter. Am J Transplant 2020; 20(7): 1800-8.
[http://dx.doi.org/10.1111/ajt.15941] [PMID: 32330343]
[11]
Fernández-Ruiz M, Andrés A, Loinaz C, et al. COVID-19 in solid organ transplant recipients: A single-center case series from Spain. Am J Transplant 2020; 20(7): 1849-58.
[http://dx.doi.org/10.1111/ajt.15929] [PMID: 32301155]
[12]
Elias M, Pievani D, Randoux C, et al. COVID-19 infection in kidney transplant recipients: Disease incidence and clinical outcomes. J Am Soc Nephrol 2020; 31(10): 2413-23.
[http://dx.doi.org/10.1681/ASN.2020050639] [PMID: 32847984]
[13]
Webb GJ, Moon AM, Barnes E, Barritt AS, Marjot T. Determining risk factors for mortality in liver transplant patients with COVID-19. Lancet Gastroenterol Hepatol 2020; 5(7): 643-4.
[http://dx.doi.org/10.1016/S2468-1253(20)30125-4] [PMID: 32339474]
[14]
Aliakbarian M, Khodashahi R, Sabbagh MG, et al. Comparison between kidney and liver transplant recipients admitted to a referral center regarding coronavirus-2019 manifestations in the Northeast of Iran During Three Peaks of Pandemic. Curr Respir Med Rev 2021; 17(4): 232-41.
[http://dx.doi.org/10.2174/1573398X17666211122160608]
[15]
Banerjee D, Popoola J, Shah S, Ster IC, Quan V, Phanish M. COVID-19 infection in kidney transplant recipients. Kidney Int 2020; 97(6): 1076-82.
[http://dx.doi.org/10.1016/j.kint.2020.03.018] [PMID: 32354637]
[16]
Tovikkai C, Charman SC, Praseedom RK, Gimson AE, van der Meulen J. Time-varying impact of comorbidities on mortality after liver transplantation: a national cohort study using linked clinical and administrative data. BMJ Open 2015; 5(5): e006971.
[http://dx.doi.org/10.1136/bmjopen-2014-006971] [PMID: 25976762]
[17]
Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[18]
Huang JF, Zheng KI, George J, et al. Fatal outcome in a liver transplant recipient with COVID-19. Am J Transplant 2020; 20(7): 1907-10.
[http://dx.doi.org/10.1111/ajt.15909] [PMID: 32277591]
[19]
Patrono D, Lupo F, Canta F, et al. Outcome of COVID‐19 in liver transplant recipients: A preliminary report from Northwestern Italy. Transpl Infect Dis 2020; 22(5): e13353.
[http://dx.doi.org/10.1111/tid.13353] [PMID: 32500942]
[20]
Khodashahi R, Aliakbarian M, Khodashahi M. Impact of immunosuppressant agents on post liver transplant patients with COVID-19. Curr Respir Med Rev 2021; 17(4): 260-8.
[http://dx.doi.org/10.2174/1573398X17666211206152126]
[21]
Wang F, Nie J, Wang H, et al. Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia. J Infect Dis 2020; 221(11): 1762-9.
[http://dx.doi.org/10.1093/infdis/jiaa150] [PMID: 32227123]
[22]
Brennan DC, Legendre C, Patel D, et al. Cytomegalovirus incidence between everolimus versus mycophenolate in de novo renal transplants: Pooled analysis of three clinical trials. Am J Transplant 2011; 11(11): 2453-62.
[http://dx.doi.org/10.1111/j.1600-6143.2011.03674.x] [PMID: 21812923]
[23]
Willicombe M, Thomas D, McAdoo S. COVID-19 and calcineurin inhibitors: should they get left out in the storm? J Am Soc Nephrol 2020; 31(6): 1145-6.
[http://dx.doi.org/10.1681/ASN.2020030348] [PMID: 32312797]
[24]
Ritchie AI, Singanayagam A. Immunosuppression for hyperinflammation in COVID-19: A double-edged sword? Lancet 2020; 395(10230): 1111.
[http://dx.doi.org/10.1016/S0140-6736(20)30691-7] [PMID: 32220278]
[25]
Minotti C, Tirelli F, Barbieri E, Giaquinto C, Donà D. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect 2020; 81(1): e61-6.
[http://dx.doi.org/10.1016/j.jinf.2020.04.026] [PMID: 32335173]
[26]
Early description of coronavirus 2019 disease in kidney transplant recipients in New York. J Am Soc Nephrol 2020; 31(6): 1150-6.
[http://dx.doi.org/10.1681/ASN.2020030375] [PMID: 32317402]
[27]
Becchetti C, Zambelli MF, Pasulo L, et al. COVID-19 in an international European liver transplant recipient cohort. Gut 2020; 69(10): 1832-40.
[http://dx.doi.org/10.1136/gutjnl-2020-321923] [PMID: 32571972]
[28]
Gao F, Zheng KI, Gu J-Y, George J, Zheng M-H. COVID-19 and liver transplantation: Lessons learned from three reported cases. Transpl Infect Dis 2020; 22(4): e13335.

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