Transplant Trial Watch

COVID-19 in hospitalized liver transplant recipients: an early systematic review and meta-analysis.

Jayant, K., et al

Clinical Transplantation 2021 [record in progress].

This study aimed to evaluate the impact of COVID-19 in liver transplant patients.

Databases, including PubMed, MEDLINE, MedRxiv, Crossref, EMBASE, Cochrane, Scopus, and clinical trial registries, were searched. Two independent reviewers were involved in the selection of eligible studies. The methodological quality of the included studies were assessed using the National Institutes of Health in the Quality Assessment Tool for Case Series Studies.

12 studies were included in the review.

The main outcomes of interest were clinical presentation, respiratory disease severity, hospital and intensive care unit admission, requirement for mechanical ventilation, incidence of acute respiratory distress syndrome, acute kidney injury, levels of lymphocytes in the blood, serum bilirubin, liver enzymes and inflammatory markers, changes in immunosuppressive regimen, administration of other treatments, mortality, graft rejection and recovery.


CET Conclusions
This systematic review and meta-analysis evaluates the literature regarding liver transplant recipients diagnosed with COVID-19 during the first year of the pandemic. The authors identify 12 retrospective case series and summarise patient characteristics, outcomes and management. The review is well conducted and well written. Clearly there are limitations when looking at observational data of this nature, in particular given the fast-paced movement of our understanding of COVID-19 during the last year, which mean that treatment and outcomes have likely evolved during the study period. The authors don’t really address the potential for publication or reporting bias. Perhaps as a result of these limitations, considerable heterogeneity is seen in many of the analyses, but nonetheless, the article provides a clear summary of the data published so far.

Trial registration
PROSPERO - CRD42020191699

Funding source
No funding received