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. 2023 Jul 3;12(13):4466.
doi: 10.3390/jcm12134466.

Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study

Sami Akbulut  1   2   3 , Fatma Hilal Yagin  2 , Tevfik Tolga Sahin  1 , Ibrahim Umar Garzali  1   4 , Adem Tuncer  1 , Musap Akyuz  5 , Nazlican Bagci  5 , Bora Barut  1 , Selver Unsal  6 , Kemal Baris Sarici  1 , Serdar Saritas  5 , Ali Ozer  3 , Recep Bentli  7 , Cemil Colak  2 , Yasar Bayindir  8 , Sezai Yilmaz  1
Affiliations

Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study

Sami Akbulut et al. J Clin Med. .

Abstract

Background: In liver transplant (LT) recipients, immunosuppressive therapy may potentially increase the risk of severe COVID-19 and may increase the mortality in patients. However, studies have shown conflicting results, with various studies reporting poor outcomes while the others show no difference between the LT recipients and healthy population. The aim of this study is to determine the impact of the COVID-19 pandemic on survival of LT recipients.

Methods: This is a retrospective cohort study analyzing the data from 387 LT recipients diagnosed with COVID-19. LT recipients were divided into two groups: survival (n = 359) and non-survival (n = 28) groups. A logistic regression model was used to determine the independent risk factors for mortality. Machine learning models were used to analyze the contribution of independent variables to the mortality in LT recipients.

Results: The COVID-19-related mortality rate in LT recipients was 7.2%. Multivariate analysis showed that everolimus use (p = 0.012; OR = 6.2), need for intubation (p = 0.001; OR = 38.4) and discontinuation of immunosuppressive therapy (p = 0.047; OR = 7.3) were independent risk factors for mortality. Furthermore, COVID-19 vaccination reduced the risk of mortality by 100 fold and was the single independent factor determining the survival of the LT recipients.

Conclusion: The effect of COVID-19 infection on LT recipients is slightly different from the effect of the disease on the general population. The COVID-19-related mortality is lower than the general population and vaccination for COVID-19 significantly reduces the risk of mortality.

Keywords: COVID-19 pandemic; COVID-19 vaccine; immunosuppressive agents; liver transplantation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Diagram of the methodology for ML estimation of mortality in LT patients with COVID-19.
Figure 2
Figure 2
Significance plot for mortality prediction of various variables.
See this image and copyright information in PMC

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