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COVID-19 in an international European liver transplant recipient cohort

(2020) GUT. 69(10). p.1832-1840
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Abstract
Objective: Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection. Design: We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected. Results: 57 patients were included (70% male, median (IQR) age at diagnosis 65 (57–70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer. Conclusion: In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.
Keywords
INFECTION, MORTALITY, orthotopic liver transplantation, chronic liver disease, infectious, disease

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MLA
Becchetti, Chiara, et al. “COVID-19 in an International European Liver Transplant Recipient Cohort.” GUT, vol. 69, no. 10, 2020, pp. 1832–40, doi:10.1136/gutjnl-2020-321923.
APA
Becchetti, C., Zambelli, M. F., Pasulo, L., Donato, M. F., Invernizzi, F., Detry, O., … Dufour, J.-F. (2020). COVID-19 in an international European liver transplant recipient cohort. GUT, 69(10), 1832–1840. https://doi.org/10.1136/gutjnl-2020-321923
Chicago author-date
Becchetti, Chiara, Marco Fabrizio Zambelli, Luisa Pasulo, Maria Francesca Donato, Federica Invernizzi, Olivier Detry, Geraldine Dahlqvist, et al. 2020. “COVID-19 in an International European Liver Transplant Recipient Cohort.” GUT 69 (10): 1832–40. https://doi.org/10.1136/gutjnl-2020-321923.
Chicago author-date (all authors)
Becchetti, Chiara, Marco Fabrizio Zambelli, Luisa Pasulo, Maria Francesca Donato, Federica Invernizzi, Olivier Detry, Geraldine Dahlqvist, Olga Ciccarelli, Maria Cristina Morelli, Montserrat Fraga, Gianluca Svegliati-Baroni, Hans Van Vlierberghe, Minneke J. Coenraad, Mario Cristobal Romero, Andrea de Gottardi, Pierluigi Toniutto, Luca Del Prete, Claudia Abbati, Didier Samuel, Jacques Pirenne, Frederik Nevens, and Jean-Francois Dufour. 2020. “COVID-19 in an International European Liver Transplant Recipient Cohort.” GUT 69 (10): 1832–1840. doi:10.1136/gutjnl-2020-321923.
Vancouver
1.
Becchetti C, Zambelli MF, Pasulo L, Donato MF, Invernizzi F, Detry O, et al. COVID-19 in an international European liver transplant recipient cohort. GUT. 2020;69(10):1832–40.
IEEE
[1]
C. Becchetti et al., “COVID-19 in an international European liver transplant recipient cohort,” GUT, vol. 69, no. 10, pp. 1832–1840, 2020.
@article{8677502,
  abstract     = {{Objective: Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection.

Design: We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected.

Results: 57 patients were included (70% male, median (IQR) age at diagnosis 65 (57–70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer.

Conclusion: In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.}},
  author       = {{Becchetti, Chiara and Zambelli, Marco Fabrizio and Pasulo, Luisa and Donato, Maria Francesca and Invernizzi, Federica and Detry, Olivier and Dahlqvist, Geraldine and Ciccarelli, Olga and Morelli, Maria Cristina and Fraga, Montserrat and Svegliati-Baroni, Gianluca and Van Vlierberghe, Hans and Coenraad, Minneke J. and Romero, Mario Cristobal and de Gottardi, Andrea and Toniutto, Pierluigi and Del Prete, Luca and Abbati, Claudia and Samuel, Didier and Pirenne, Jacques and Nevens, Frederik and Dufour, Jean-Francois}},
  issn         = {{0017-5749}},
  journal      = {{GUT}},
  keywords     = {{INFECTION,MORTALITY,orthotopic liver transplantation,chronic liver disease,infectious,disease}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1832--1840}},
  title        = {{COVID-19 in an international European liver transplant recipient cohort}},
  url          = {{http://dx.doi.org/10.1136/gutjnl-2020-321923}},
  volume       = {{69}},
  year         = {{2020}},
}

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