The Outcome of Critical-phase COVID-19 in Liver Transplant Recipients

Background Considering the importance of assessing solid organ transplants, infected individuals with coronavirus disease 2019 (COVID-19), and the lack of information in this regard, this descriptive study aimed to investigate the clinical features, immunosuppressive agents, and outcomes of liver transplant recipients in the critical phase of infection with COVID-19. Methods This descriptive cross-sectional study was conducted on 12 critically ill liver transplant recipients referred to Imam Reza and Montaseriyeh hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, within 2020-21. The required data, including demographic and clinical information, were gathered and recorded in a checklist, and the correlations between variables were assessed in SPSS software (version 24). Results Hypertension, diabetes, and chronic kidney disease were reported in 83.3% (n = 10), 58.3% (n = 7), and 41.6% (n = 5) of patients, respectively. The administration of Mycophenolic acid was correlated with conjunctivitis (r = -0.67; P = 0.02), weakness (r = 0.77; P = 0.006), and sore throat (r = -0.67; P = 0.02). Ground glass opacity was reported in all patients, which was along with consolidation in 90.9% of the cases, and acute pulmonary embolism was found in 36.3% of the subjects. Finally, 66.7% (n = 8) of patients passed away. Among immunosuppressive agents, only the use of Mycophenolic acid was correlated with the outcome (r = -0.77; P = 0.006). Conclusion Due to the high rate of mortality among liver transplant recipients in the critical phase of COVID-19, earlier and more aggressive treatment with antiviral and antibacterial agents should be performed in this group of patients.