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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
- Source :
- Belli , L S , Fondevila , C , ELITA-ELTR COVID-19 Registry , Cortesi , P A , Conti , S , Karam , V , Adam , R , Coilly , A , Ericzon , B G , Loinaz , C , Cuervas-Mons , V , Zambelli , M , Llado , L , Diaz-Fontenla , F , Invernizzi , F , Patrono , D , Faitot , F , Bhooori , S , Pirenne , J , Perricone , G , Magini , G , Castells , L , Detry , O , Cruchaga , P M , Colmenero , J , Berrevoet , F , Rodriguez , G , Ysebaert , D , Radenne , S , Metselaar , H , Morelli , C , De Carlis , L G , Polak , W G & Duvoux , C 2021 , ' 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 ' , Gastroenterology , vol. 160 , no. 4 , pp. 1151-1163.e3 .
- Publication Year :
- 2021
-
Abstract
- Background and Aims: 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 1 and June 27, 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 of 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 percent 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.
Details
- Database :
- OAIster
- Journal :
- Belli , L S , Fondevila , C , ELITA-ELTR COVID-19 Registry , Cortesi , P A , Conti , S , Karam , V , Adam , R , Coilly , A , Ericzon , B G , Loinaz , C , Cuervas-Mons , V , Zambelli , M , Llado , L , Diaz-Fontenla , F , Invernizzi , F , Patrono , D , Faitot , F , Bhooori , S , Pirenne , J , Perricone , G , Magini , G , Castells , L , Detry , O , Cruchaga , P M , Colmenero , J , Berrevoet , F , Rodriguez , G , Ysebaert , D , Radenne , S , Metselaar , H , Morelli , C , De Carlis , L G , Polak , W G & Duvoux , C 2021 , ' 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 ' , Gastroenterology , vol. 160 , no. 4 , pp. 1151-1163.e3 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1322185191
- Document Type :
- Electronic Resource