Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study.

Publication date: Jul 03, 2023

In liver transplant (LT) recipients, immunosuppressive therapy may potentially increase the risk of severe COVID-19 and may increase the mortality in patients. However, studies have shown conflicting results, with various studies reporting poor outcomes while the others show no difference between the LT recipients and healthy population. The aim of this study is to determine the impact of the COVID-19 pandemic on survival of LT recipients. This is a retrospective cohort study analyzing the data from 387 LT recipients diagnosed with COVID-19. LT recipients were divided into two groups: survival (n = 359) and non-survival (n = 28) groups. A logistic regression model was used to determine the independent risk factors for mortality. Machine learning models were used to analyze the contribution of independent variables to the mortality in LT recipients. The COVID-19-related mortality rate in LT recipients was 7. 2%. Multivariate analysis showed that everolimus use (p = 0. 012; OR = 6. 2), need for intubation (p = 0. 001; OR = 38. 4) and discontinuation of immunosuppressive therapy (p = 0. 047; OR = 7. 3) were independent risk factors for mortality. Furthermore, COVID-19 vaccination reduced the risk of mortality by 100 fold and was the single independent factor determining the survival of the LT recipients. The effect of COVID-19 infection on LT recipients is slightly different from the effect of the disease on the general population. The COVID-19-related mortality is lower than the general population and vaccination for COVID-19 significantly reduces the risk of mortality.

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Concepts Keywords
Everolimus COVID-19 pandemic
Pandemic COVID-19 vaccine
Transplant immunosuppressive agents
Vaccination liver transplantation


Type Source Name
disease MESH COVID-19 Pandemic
disease VO population
drug DRUGBANK Everolimus
disease VO vaccination
disease MESH infection
disease MESH Infectious Diseases
drug DRUGBANK Coenzyme M
disease VO vaccine
disease MESH pneumonia
disease MESH viral pneumonia
disease MESH severe acute respiratory syndrome
pathway REACTOME Infectious disease
disease IDO infectious disease
disease MESH Emergency
disease MESH death
disease MESH cytokine storm
disease MESH superinfection
disease MESH obesity
disease MESH hypertension
disease MESH cardiovascular disease
disease MESH chronic obstructive pulmonary disease
disease MESH end stage renal disease
disease MESH liver disease
disease MESH malignancy
disease MESH leukopenia
disease MESH acute kidney injury
disease VO dose
disease VO volume
disease IDO blood
disease MESH marital status
disease MESH comorbidity
disease MESH diabetes mellitus
disease MESH pulmonary disease
drug DRUGBANK Tacrolimus
drug DRUGBANK Mycophenolate mofetil
drug DRUGBANK Monomethyl fumarate
drug DRUGBANK Trestolone
drug DRUGBANK L-Alanine
disease VO dead
disease MESH multiple organ failure
disease VO protocol
disease VO USA
disease IDO algorithm
disease IDO process
drug DRUGBANK Prednisolone
disease MESH complications
disease IDO history
disease MESH Anorexia
disease MESH Backache
disease MESH joint pain
disease IDO symptom
disease MESH inflammation
disease MESH clinical importance
disease VO immunization
disease VO COVID-19 vaccine

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