key: cord-0916291-zepfc6yr
authors: Regmi, Parbatraj; Liu, Fei; Li, Fu-Yu
title: Characteristics of Liver transplant patients infected with COVID-19.
date: 2021-01-16
journal: Gastroenterology
DOI: 10.1053/j.gastro.2021.01.032
sha: 120768caea812d0ac3adbfe82bc4ce6aa0a2a419
doc_id: 916291
cord_uid: zepfc6yr

nan

To the editor, With great interest, we have read this multi-center research network study from Mansoor and colleagues entitled "Clinical Characteristics, Hospitalization and Mortality Rates of COVID-19 Among Liver Transplant Patients in the United States". [1] The study had described the characteristics of liver transplant (LT) patients infected with COVID-19 and the rates of hospitalization, mortality, thrombosis, and Intensive Care Unit (ICU) requirements. Within their study, fever (10%) was the most common presenting symptom followed by cough (8%), malaise and fatigue (8%), dyspnea (10%), and gastrointestinal (GI) symptoms (8%). The incidence of hospitalization, ICU care, and mortality among LT patients were 40%, 8%, and 8% respectively, and these outcomes were significantly higher than the non-LT cohort. The study was designed retrospectively with incomplete documentation and recall bias. The sample size was not large enough to support the results with high confidence. Moreover, the presenting symptoms, hospitalization, ICU care, and mortality among liver transplant patients were lower than reported by the other two multicenter studies from Spain and Europe. [2, 3] We have performed a single-arm meta-analysis from data of three multicenter studies including the present study using OpenMeta The results of our single-arm meta-analysis also showed that the order of presenting symptoms was similar to this study. However, the proportion of patients presenting with those symptoms were significantly higher than reported The proportion of patients presenting with fatigue and malaise was 31.7% (95% CI: -15.6-78.9). Finally, the proportion of patients presenting with GI symptoms was 24.2% (95% CI: 4.7-43.7). Our study showed that 66.1% (95% CI: 35.8-96.3) were hospitalized, which was higher than the present study.

Patients who required ICU care and mortality were 8.6% (95% CI: 5.4-11.8), and 12.3% (95% CI: 6.0-18.6) respectively, which were not significantly higher than the present study.

Moreover, this study had not analyzed the risk factor of severe COVID among hospitalized patients with LT. An earlier study by Colmenero In conclusion, patients with LT have worse clinical outcomes of COVID-19 than those without LT. Further studies regarding the comprehensive management of patients with LT and COVID-19 are urgently needed to provide better health care to this patient population. 

Clinical Characteristics, Hospitalization and Mortality Rates of COVID-19 Among Liver Transplant Patients in the United States: A Multi-Center Research Network Study

COVID-19 in an international European liver transplant recipient cohort

Epidemiological pattern, incidence and outcomes of COVID-19 in liver transplant patients

Determining risk factors for mortality in liver transplant patients with COVID-19