COVID-19 in Liver Transplant Recipients

Background and Aims:Coronavirus disease 2019(COVID-19)has infected over 93 million people worldwide as of January 14,2021.Various studies have gathered data on liver transplant patients infected with COVID-19.Here,we discuss the presentation of COVID-19 in immunosuppressed patients with prior liver transplants.We also evaluate patient outcomes after infection.Methods:We searched the PubMed database for all studies focused on liver transplant patients with COVID-19.Results:We identified eight studies that evaluated COVID-19 infection in liver transplant patients(n=494).Hypertension was the most prevalent comorbidity in our cohort.Calcineurin inhibitors were the most common immunosuppressant medications in the entire cohort.The average time from liver transplant to COVID-19 infection in our cohort was 74.1 months.Fever and cough,at 70%and 62%respectively,were the most common symptoms in our review.In total,50%of the patients received hydroxychloroquine as treatment for COVID-19.The next most prevalent treatment was azithromycin,given to 30%of patients in our cohort.In total,80%of the patients were admitted to a hospital and 17%required intensive care unit-level care,with 21%having required mechanical ventilation.Overall mortality was 17%in our review.Conclusions:Given the immunocompromised status of liver transplant patients,more intensive surveillance is necessary for severe cases of COVID-19 infection.As liver transplantations have been restricted during the COVID-19 pandemic,further investigation is warranted for studying the risk of COVID-19 infection in liver transplant patients.