A study involving Oxford researchers has found that having had a liver transplant does not increase the risk of death from COVID-19, but that other factors such as age and comorbidities among liver transplant recipients do. The researchers from the Oxford Liver Unit, based at Oxford University Hospitals (OUH) NHS Foundation Trust, and the University of Oxford’s Centre for Statistics in Medicine were looking to assess the clinical outcomes in patients with liver transplants amid concerns they might be at increased risk of adverse outcomes from COVID-19 because of coexisting comorbidities and use of immunosuppressants.
However, the team, who were supported by the NIHR Oxford Biomedical Research Centre, found that the effect of coronavirus infection on this patient group remained unclear.
While liver transplantation was not independently associated with death, increased age and the presence of comorbidities were.
“Factors other than transplantation should be preferentially considered in relation to physical distancing and provision of medical care for patients with liver transplants during the COVID-19 pandemic,” the study published in the Lancet concluded.
The multi-centre study looked at data from 778 patients with laboratory-confirmed SARS-CoV-2 infection from 18 countries, 151 of whom were adult liver transplant recipients, and 627 who had not received a liver transplant. The two cohorts were compared with regard to outcomes such as death, hospitalisation, admission to an intensive care unit, the need for invasive ventilation etc.
There was little difference between the two groups with regard to the proportion hospitalised or requiring intensive care.
While those who had had a liver transplant were more likely to need ICU admission and invasive ventilation, a larger percentage of the non-liver transplant cohort died.
Nonetheless, multivariable logistic regression analysis showed that age, serum creatinine concentration, and non-liver cancer were associated with death among liver transplant recipients.
“Liver transplantation was not independently associated with death, whereas increased age and presence of comorbidities were,” the study concluded. “Factors other than transplantation should be preferentially considered in relation to physical distancing and provision of medical care for patients with liver transplants during the COVID-19 pandemic.”
An earlier study by the group had found high mortality rates from COVID-19 among people with chronic liver disease and cirrhosis.