LitCovid-sentences  

PMC:7335697 / 27128-32497 JSONTXT 12 Projects

Annnotations TAB TSV DIC JSON TextAE

Id Subject Object Predicate Lexical cue
T338 0-10 Sentence denotes Discussion
T339 11-256 Sentence denotes In this observational prospective multicentre study, we report the characteristics, early outcome and management of the COVID-19 outbreak on the largest European cohort of liver transplant patients with confirmed SARS-CoV-2 infection up to date.
T340 257-405 Sentence denotes Case fatality rate of the overall study population was 12% (95% CI 5% to 24%), whereas that of the hospitalised patients was 17% (95% CI 7% to 32%).
T341 406-630 Sentence denotes This latter is in line with that of the general population, as reported by most of the largest studies, where the in-hospital case fatality rate ranges from 15% to 22%.1 25 26 All the patients who died, except one, were men.
T342 631-827 Sentence denotes CV disease, obesity, arterial hypertension, diabetes mellitus and chronic kidney disease, although well represented in our population, were not over-represented in the group with adverse outcomes.
T343 828-978 Sentence denotes A clinical history of neoplasia, especially an active cancer at the moment of the diagnosis, was frequently found in the group with a worse prognosis.
T344 979-1147 Sentence denotes Recently transplanted patients presented with less fever and respiratory-related symptoms than patients who were transplanted for more than 1 and 5 years, respectively.
T345 1148-1248 Sentence denotes Among laboratory data, lymphocytopenia and thrombocytopenia were more frequent in patients who died.
T346 1249-1354 Sentence denotes Alteration in liver enzymes was mild and rarely observed, although mostly found in hospitalised patients.
T347 1355-1442 Sentence denotes Whether the immunosuppression was decreased or left unchanged had no impact on outcome.
T348 1443-2462 Sentence denotes Our study suggests that, despite well-described risk factors for poor outcome of COVID-19 infection are highly represented in our cohort, COVID-19 liver transplant patients show a clinical course not necessarily more severe to that observed in non-liver transplant patients affected by COVID-19.25–27 Publications pooling patients with different organ transplanted reported worse outcomes (in-hospital case fatality rate 24%–27%).11 13 Another publication merging surveys from European and American centres with a smaller sample than our prospective study reported 9 deaths among 39 liver transplant patients.28 Like others, we find that male patients are more prone to develop ARDS29 and have a more severe outcome.25 Although highly frequent in our cohort, CV and metabolic comorbidities were not over-represented in patients with poor outcomes.25 26 History of previous or active cancer, such as being transplanted for HCC or having cancer at the moment of the COVID-19 diagnosis, was associated with a poor outcome.
T349 2463-2688 Sentence denotes This is in agreement with a national Chinese report on over 2000 confirmed COVID-19 cases with a history of cancer, showing them having higher risk to contract COVID-19 and poorer outcome than individuals without cancer.30 31
T350 2689-2812 Sentence denotes Concerning clinical presentation, patients transplanted for less than 5 years exhibited less frequently fever and dyspnoea.
T351 2813-2901 Sentence denotes This may suggest higher immunosuppression attenuates COVID-19 typical clinical symptoms.
T352 2902-3040 Sentence denotes GI manifestations were common (33%) in our series, which is in line with the 29% reported in solid organ transplant recipients in Spain.11
T353 3041-3222 Sentence denotes Lymphopenia has been reported to be predictive of poor outcome in non-transplanted COVID-19 patients.29 32 A similar trend was found also in our cohort of liver transplant patients.
T354 3223-3465 Sentence denotes One of the key questions in the management of liver transplant patients affected with COVID-19 concerns the management of the immunosuppression.33 In our cohort, the immunosuppression was reduced in 39% of the patients and discontinued in 7%.
T355 3466-3522 Sentence denotes Mycophenolate mofetil was the most discontinued therapy.
T356 3523-3652 Sentence denotes The majority of the patients with COVID-19 who did not need a hospitalisation were kept on their usual immunosuppressive regimen.
T357 3653-3903 Sentence denotes Although some reports want to suggest a potential positive role of tacrolimus as antiviral in the treatment of human coronaviruses,34 since 88% of our patients were treated with CNIs, it was not possible to assess any specific effect of this therapy.
T358 3904-3930 Sentence denotes Our study has limitations.
T359 3931-3974 Sentence denotes All the participating centres are European.
T360 3975-4054 Sentence denotes It will be important to have similar prospective studies from other continents.
T361 4055-4152 Sentence denotes We limited our analysis to the patients with a positive reverse transcription PCR for SARS-CoV-2.
T362 4153-4282 Sentence denotes We did not include patients with typical presentation but without a microbiological confirmation due to lack of testing capacity.
T363 4283-4709 Sentence denotes On the other hand, the NAAT assay as the recommended confirmatory test has a sensitivity in the order of 71%,35 and this could be lower in immunosuppressed population.13 Moreover, although liver transplant patients were generally well instructed to contact their transplant centre as far as COVID-like symptoms appeared, we cannot exclude a global underestimation of the total number of COVID-19 infections in this population.
T364 4710-4734 Sentence denotes Our study has strengths.
T365 4735-4845 Sentence denotes It is, at the time of writing, the largest prospective study of liver recipient patients affected by COVID-19.
T366 4846-4949 Sentence denotes It is by design not a survey but a prospective acquisition of data approved by local ethics committees.
T367 4950-5185 Sentence denotes In conclusion, in this European multicentre prospective study of liver transplant recipients, COVID-19 is associated with an overall and in-hospital case fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively.
T368 5186-5298 Sentence denotes Patients infected early after liver transplantation did not have a worse outcome and tend to have less symptoms.
T369 5299-5369 Sentence denotes A history of cancer was more frequent in patients with poorer outcome.