Covid-19 in liver transplant recipients: the French SOT COVID registry.

Pauline Houssel-Debry, Faouzi Saliba, Marc Hazzan, Claire Vanlemmens, Jean-Philippe Richardet, Sylvie Radenne, Lucy Meunier, Alessandra Mazzola, Maxime Mallet, Vincent Leroy, Noémie Laverdure, Guillaume Lassailly, Ilias Kounis, Jérôme Dumortier, Florentine Garaix, Claire Francoz, François Durand, Sébastien Dharancy, Filomena Conti, Audrey Coilly, Sophie Caillard, Camille Besch, Hélène Barraud, Mario Altieri, Olivier Roux, Christophe Duvoux

Journal: Clinics and research in hepatology and gastroenterology 2021;45(4):101639

PMID: 33636654

Abstract

[{"label":"BACKGROUND","text":"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."},{"label":"METHODS","text":"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."},{"label":"RESULTS","text":"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\u202f-\u202f73.2 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\u202f-\u202f194.7 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 During hospitalization, antimetabolites, mTOR inhibitor, and CNIs were withdrawn in 41.9%, 30.0% and 12.5% of patients, respectively.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."},{"label":"CONCLUSION","text":"In our large nationwide study, Covid-19 in LT recipients was associated with a high mortality rate."},{"copyright":"Copyright \u00a9 2021 Elsevier Masson SAS. All rights reserved."}]
Address: Hospices Civils de Lyon, Hôpital Edouard Herriot, Unité de Transplantation Hépatique et Université Claude Bernard Lyon 1, Lyon, France. Electronic address: [email protected].; APHP, Hôpital Henri Mondor, Service d'Hépatologie, Créteil, France.; APHP, Hôpital Beaujon, Service d'Hépatologie et Transplantation Hépatique - Université Paris Diderot - INSERM U1149, Clichy, France.; Hôpital Côte de Nacre, Service d'Hépato-Gastroentérologie, Nutrition et Oncologie Digestive, Caen, France.; CHU Tours, Hôpital Trousseau Service de Chirurgie Digestive, Oncologique et Endocrinienne, Transplantation Hépatique, Tours, France.; CHRU Hautepierre, Service de Chirurgie Hépato-Bilio-Pancréatique et Transplantation Hépatique, Strasbourg, France.; CHRU Hautepierre, Service de Néphrologie et Transplantation et INSERM, IRM UMR-S 1109, Strasbourg, France.; AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, INSERM, Unité 1193, Villejuif, France.; APHP - Hôpital de la Pitié Salpétrière, Service d'Hépatologie et Transplantation Hépatique, Paris, France.; CHRU Lille, Hôpital Claude Huriez, Service des Maladies de l'appareil Digestif et Université de Lille, Lille, France.; APHM, Hôpital La Timone, Service de Pédiatrie Multidisciplinaire, Marseille, France.; Hôpital Universitaire de Pontchaillou, Service d'Hépatologie et Transplantation Hépatique, Rennes, France.; Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Unité d'Hépato-gastroentérologie et Nutrition Pédiatriques, Lyon, France.; CHU Saint Eloi, Département d'Hépatologie et Transplantation Hépatique, Montpellier, France.; Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Hépato-Gastroentérologie, Lyon, France.; Hôpital Jean Minjoz, Service d'Hépatologie et Soins Intensifs Digestifs, Besançon, France.; CHRU Lille, Hôpital Claude Huriez, Service de Néphrologie et Transplantation et Université de Lille, Lille, France.
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