Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study
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 differenc...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4466 |
| _version_ | 1797591432342536192 |
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| author | Sami Akbulut Fatma Hilal Yagin Tevfik Tolga Sahin Ibrahim Umar Garzali Adem Tuncer Musap Akyuz Nazlican Bagci Bora Barut Selver Unsal Kemal Baris Sarici Serdar Saritas Ali Ozer Recep Bentli Cemil Colak Yasar Bayindir Sezai Yilmaz |
| author_facet | Sami Akbulut Fatma Hilal Yagin Tevfik Tolga Sahin Ibrahim Umar Garzali Adem Tuncer Musap Akyuz Nazlican Bagci Bora Barut Selver Unsal Kemal Baris Sarici Serdar Saritas Ali Ozer Recep Bentli Cemil Colak Yasar Bayindir Sezai Yilmaz |
| author_sort | Sami Akbulut |
| collection | DOAJ |
| description | 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 (<i>n</i> = 359) and non-survival (<i>n</i> = 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 (<i>p</i> = 0.012; OR = 6.2), need for intubation (<i>p</i> = 0.001; OR = 38.4) and discontinuation of immunosuppressive therapy (<i>p</i> = 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. |
| first_indexed | 2024-03-11T01:37:21Z |
| format | Article |
| id | doaj.art-a0b822b480e74ae88ca543ee92b080d8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:37:21Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a0b822b480e74ae88ca543ee92b080d82023-11-18T16:54:17ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011213446610.3390/jcm12134466Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort StudySami Akbulut0Fatma Hilal Yagin1Tevfik Tolga Sahin2Ibrahim Umar Garzali3Adem Tuncer4Musap Akyuz5Nazlican Bagci6Bora Barut7Selver Unsal8Kemal Baris Sarici9Serdar Saritas10Ali Ozer11Recep Bentli12Cemil Colak13Yasar Bayindir14Sezai Yilmaz15Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgical Nursing, Inonu University Faculty of Nursing, Malatya 44280, TurkeyDepartment of Surgical Nursing, Inonu University Faculty of Nursing, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Nursing Service, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgical Nursing, Inonu University Faculty of Nursing, Malatya 44280, TurkeyDepartment of Public Health, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Internal Medicine, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Infectious Diseases and Clinical Microbiology, Inonu University Faculty of Medicine, Malatya 44280, TurkeyDepartment of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, TurkeyBackground: 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 (<i>n</i> = 359) and non-survival (<i>n</i> = 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 (<i>p</i> = 0.012; OR = 6.2), need for intubation (<i>p</i> = 0.001; OR = 38.4) and discontinuation of immunosuppressive therapy (<i>p</i> = 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.https://www.mdpi.com/2077-0383/12/13/4466COVID-19 pandemicliver transplantationimmunosuppressive agentsCOVID-19 vaccine |
| spellingShingle | Sami Akbulut Fatma Hilal Yagin Tevfik Tolga Sahin Ibrahim Umar Garzali Adem Tuncer Musap Akyuz Nazlican Bagci Bora Barut Selver Unsal Kemal Baris Sarici Serdar Saritas Ali Ozer Recep Bentli Cemil Colak Yasar Bayindir Sezai Yilmaz Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study Journal of Clinical Medicine COVID-19 pandemic liver transplantation immunosuppressive agents COVID-19 vaccine |
| title | Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study |
| title_full | Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study |
| title_fullStr | Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study |
| title_full_unstemmed | Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study |
| title_short | Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study |
| title_sort | effect of covid 19 pandemic on patients who have undergone liver transplantation retrospective cohort study |
| topic | COVID-19 pandemic liver transplantation immunosuppressive agents COVID-19 vaccine |
| url | https://www.mdpi.com/2077-0383/12/13/4466 |
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