Evaluation of Factors Affecting the Outcome of COVID-19 in Patients with Liver Transplantation

Fateme Ziamanesh, Hamidreza Kariminejad Dizbuni, Foroogh Alborzi Avanaki, Mohammad Taher

Abstract


Background:

 In patients undergoing liver transplantation (LT), the risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the severity of the consequences are almost unknown. Therefore, this study aimed to examine the influencing factors in the relationship between LT and the consequences of  coronavirus disease 2019 (COVID-19).

Materials and Methods:

 In this cross-sectional study, all individuals with a history of LT who contracted COVID-19 through the Liver Transplantation Clinic, Imam Khomeini Hospital Complex, Tehran, Iran, were recruited during the 2 years of the COVID-19 pandemic from March 2020 to March 2022.

The required data were extracted from patients’ medical records and hospital databases. The analyses were conducted using IBM SPSS software version 22.

Results:

162 patients were studied. The mortality prevalence was 24.1%. A significant relationship was found between COVID-19 severity and the number of LTs, presence of pulmonary involvement, need for remdesivir and steroid treatment, and death. Also, a significant relationship was found between death and age at the time of LT, lung involvement, early infection (within one month after LT) with COVID-19, and the need for hospitalization due to COVID-19.

A significant relationship was found between liver enzyme disorders (elevated alanine and aspartate transferase levels [>40 U/L] and bilirubin levels [>1.5 mg/dL]) and early infection with COVID-19, severe COVID-19 involvement, pulmonary involvement, need for remdesivir and steroid treatment, and death due to COVID-19.

Conclusion:

Advanced age, pulmonary involvement, dependence on corticosteroid and remdesivir treatment, the number of LTs, and elevated liver enzyme levels were significant risk factors associated with severe COVID-19 and mortality.


Keywords


COVID-19, Liver transplantation, Prognosis

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