Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Version 1 : Received: 30 April 2022 / Approved: 9 May 2022 / Online: 9 May 2022 (03:59:57 CEST)

A peer-reviewed article of this Preprint also exists.

Freitas, A.F.; Pugliese, R.P.S.; Feier, F.; Miura, I.K.; Danesi, V.L.B.; Oliveira, E.N.; Hirschfeld, A.P.M.; Borges, C.B.V.; Lobato, J.V.; Porta, G.; Seda-Neto, J.; Fonseca, E.A. Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center. Microorganisms 2022, 10, 1030. Freitas, A.F.; Pugliese, R.P.S.; Feier, F.; Miura, I.K.; Danesi, V.L.B.; Oliveira, E.N.; Hirschfeld, A.P.M.; Borges, C.B.V.; Lobato, J.V.; Porta, G.; Seda-Neto, J.; Fonseca, E.A. Impact of COVID-19 Infection on Children and Adolescents after Liver Transplantation in a Latin American Reference Center. Microorganisms 2022, 10, 1030.

Journal reference: Microorganisms 2022, 10, 1030
DOI: 10.3390/microorganisms10051030

Abstract

Background: COVID-19 infection has received the attention of the scientific community due 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 (LT) patients.The aim of this study was to analyze the outcomes of the larger cohort of pediatric liver transplant recipients (PLTR) from a single center in Brazil who where contaminated 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. Results: 74 PLTR were included. Patients were divided into two groups according to the severity of COVID-19 disease: moderate-severe COVID and asymptomatic-mild COVID. Patients categorized as moderate-severe COVID were younger (12.6 months vs. 82.1 months, p 0.03), higher prevalence of transplantation with deceased donor (50% vs. 4.3%, p 0.02) and with a higher prevalence of COVID-infected patients before 6 months after 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.

Keywords

COVID-19; pediatric liver transplantation; immunosuppression; living donor liver transplantation

Subject

LIFE SCIENCES, Virology

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