• Chiara Becchetti, Marco Fabrizio Zambelli, Luisa Pasulo, Maria Francesca Donato, Federica Invernizzi, Olivier Detry, Géraldine Dahlqvist, Olga Ciccarelli, Maria Cristina Morelli, Montserrat Fraga, Gianluca Svegliati-Baroni, Hans van Vlierberghe, Minneke J Coenraad, Mario Cristobal Romero, Andrea de Gottardi, Pierluigi Toniutto, Luca Del Prete, Claudia Abbati, Didier Samuel, Jacques Pirenne, Frederik Nevens, Jean-François Dufour, and COVID-LT group.
• University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland.
• Gut. 2020 Oct 1; 69 (10): 1832-1840.

ObjectiveKnowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection.DesignWe conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected.Results57 patients were included (70% male, median (IQR) age at diagnosis 65 (57-70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer.ConclusionIn this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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