Article (Scientific journals)
Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study.
Belli, Luca S.; Fondevila, Constantino; Cortesi, Paolo A. et al.
2021In Gastroenterology, 160 (4), p. 1151-1163
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Keywords :
COVID-19; Liver transplantation; Outcome; Tacrolimus; transplantation; complication; greffe; sars-cov-2; foie
Abstract :
[en] Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis, RESULTS: Between March 1st and June 27(th)2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age > 70 (HR 4.16; 95%CI 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR 0.55; 95%CI 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR 1.95; 95%CI 1.06 - 3.58) and chronic kidney disease (HR 1.97; 95%CI 1.05 - 3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.
Disciplines :
Gastroenterology & hepatology
Surgery
Author, co-author :
Belli, Luca S.
Fondevila, Constantino
Cortesi, Paolo A.
Conti, Sara
Karam, Vincent
Adam, Rene
Coilly, Audrey
Ericzon, Bo Goran
Loinaz, Carmelo
Cuervas-Mons, Valentin
Zambelli, Marco
Llado, Laura
Diaz, Fernando
Invernizzi, Federica
Patrono, Damiano
Faitot, Francois
Bhooori, Sherrie
Pirenne, Jacques
Perricone, Giovanni
Magini, Giulia
Castells, Lluis
Detry, Olivier  ;  Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne
Cruchaga, Pablo Mart
Colmenero, Jordi
Berrevoet, Frederick
Rodriguez, Gonzalo
Ysebaert, Dirk
Radenne, Sylvie
Metselaar, Herold
Morelli, Cristina
De Carlis, Luciano
Polak, Wojciech G.
Duvoux, Christophe
More authors (23 more) Less
Language :
English
Title :
Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study.
Publication date :
March 2021
Journal title :
Gastroenterology
ISSN :
0016-5085
eISSN :
1528-0012
Publisher :
Elsevier
Volume :
160
Issue :
4
Pages :
1151-1163
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.
Available on ORBi :
since 12 December 2020

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