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
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
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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
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Commentary :
Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.
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