COVID - LTX BRAZIL

INTRODUCTION Amid the current pandemic, consequences of infection in COVID-19 Liver Transplant recipients (LT) patients are of particular concern, notably due to perceived added risks  related to immunosuppression and comorbidity burden. Current literature on this topic often relies on small, non-standardized, and ethnically limited studies. This manuscript describes COVID-19 presentations and causes for elevated mortality in a diverse population of LT recipients. METHODS This study was designed as a multi-centric historical cohort, including LT recipient patients with COVID-19 in 25 study centers, with the primary endpoint being COVID-related death. We also collected demographic, clinical, and laboratory data regarding presentation and disease progression. RESULTS 254 cases were included. The study population was predominantly male, white and had a median age of 60 years. Median time from transplantation was three years (IQR 1-6). Most patients had at least one comorbidity (206, 81%). Patient age was associated with increased mortality (p = 0.04). Dyspnea was correlated with mortality (p < .001), as well as with modifications of immunosuppressive therapy (p < .001), specifically the suspension of immunosuppressive agents. CONCLUSION Attention to risk factors and the individualization of patient care, especially regarding immunosuppression management, is crucial for delivering more precise interventions to these individuals.