Incidence and Impact of COVID-19 Cases in Brazilian Liver Transplant Recipients: An Academic, Single-center Experience

• Published in: Transplantation proceedings Vol. 54; no. 5; pp. 1341 - 1344
• Main Authors: Riccetto, Eduardo, Ataide, Elaine Cristina, Perales, Simone Reges, Zanaga, Leticia, Ivano, Victor Kenzo, Ramalho, Juliana Elias, Colado, Talita, Stucchi, Raquel Silveira Bello, Boin, Ilka de Fátima Santana Ferreira
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022
• Subjects: Adult; Brazil - epidemiology; COVID-19 - epidemiology; Humans; Incidence; Liver Transplantation - adverse effects; Male; Tacrolimus; Transplant Recipients; Brazil
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2022.03.046

•Lower COVID-19 hospitalization rates in liver transplant recipients in Latin America.•Adjustments to immunosuppressive regimens in correlation with increased mortality.•Maintenance of tacrolimus in the regimen correlates with greater survival.•Fewer are affected by age and comorbidities as risk factors for COVID-19–related mortality. Current literature reports diverge on the impact of COVID-19 in liver transplant (LT) recipients. Literature findings often report conflicting results, relying on small sample sizes, limited ethnic variability, and nonstandardized methodologies. Notably, there are no studies on this topic regarding Latin American populations. This study seeks to report the impact of COVID-19, disease characteristics, and progression in LT recipients in a Latin American academic center environment. The study design was a historic cohort, including adult LT recipient patients with suspected or confirmed COVID-19 who sought care between December 2019 to October 2021. The primary end point was defined as COVID-19–related death. Demographic, clinical, and laboratory data was also collected. Twenty-seven patients were included, representing a 3.5% incidence within 752 patients in the follow-up. The mean age and years from transplantation were 54 (SD ± 11) and 6.3 years (SD ± 5.4), respectively. Most patients were white (23 - 85.2%) and male (21 - 25.2%). The hospitalization rate was 55.6%, and 5 patients (18.5%), all of whom subsequently died, were admitted to the intensive care unit. Neither the presence of comorbidities nor advanced age were related to lethality. Patients with immunosuppression modifications (P = 0.039) or isolated tacrolimus suspension (P = 0.006) were associated with increased mortality. This study described COVID-19 infections in LT recipients in Latin American populations. This group was not affected by common factors associated with higher lethality, and displayed a tendency toward lower hospitalization rates. Our study concurred with previously reported evidence of a protective association of tacrolimus maintenance during treatment in LT recipients affected by COVID-19.