https://pubmed.ncbi.nlm.nih.gov/35630472/ Transplant

Microorganisms. 2022 May 15;10(5):1030.
doi: 10.3390/microorganisms10051030.

Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center

Aline F Freitas 1, Renata P S Pugliese 1, Flavia Feier 2, Irene K Miura 1, Vera Lúcia B Danesi 1, Eliene N Oliveira 1, Adriana P M Hirschfeld 1, Cristian B V Borges 1, Juliana V Lobato 1, Gilda Porta 1, João Seda-Neto 1, Eduardo A Fonseca 1

Abstract

Background: The COVID-19 infection has received the attention of the scientific community due to its respiratory manifestations and association with evolution to severe acute respiratory syndrome (SARS-CoV-2). There are few studies characterizing SARS-CoV-2 in pediatric immunocompromised patients, such as liver transplanted patients. The aim of this study was to analyze the outcomes of the largest cohort of pediatric liver transplant recipients (PLTR) from a single center in Brazil who were infected with COVID-19 during the pandemic.

Methods: Cross-sectional study.
Primary outcomes: COVID-19 severity. The Cox regression method was used to determine independent predictors associated with the outcomes. Patients were divided into two groups according to the severity of COVID-19 disease: moderate-severe COVID and asymptomatic-mild COVID.

Results: Patients categorized as having moderate-severe COVID-19 were younger (12.6 months vs. 82.1 months, p = 0.03), had a higher prevalence of transplantation from a deceased donor (50% vs. 4.3%, p = 0.02), and had a higher prevalence of COVID infection within 6 months after liver transplantation (LT) (75% vs. 5.7%, p = 0.002). The independent predictor of COVID-19 severity identified in the multivariate analysis was COVID-19 infection <6 months after LT (HR = 0.001, 95% CI = 0.001-0.67, p = 0.03).

Conclusion: The time interval of less than 6 months between COVID-19 infection and LT was the only predictor of disease severity in pediatric patients who underwent liver transplantation.