Gender Differences in COVID-19 Among Liver Transplant Recipients: Results from a Multicenter Brazilian Cohort

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Palabras clave:

Liver Tansplantation, COVID-19, Gender-Specific Needs

Resumen

Introduction: Existing literature presents varying perspectives on the impact of COVID-19 on liver transplant recipients.However, no research has specifically investigated the role of gender differences in the manifestation of COVID-19 among liver transplant recipients. This study aims to examine the effects of COVID-19 on liver transplant recipients, with a focus on gender differences in disease presentation and progression. Methods: Conducted as a multicenter historical cohort study, this research collected patient records through an online questionnaire. Assessing COVID-related mortality was the main objective. Additionally, demographic, clinical, and laboratory data pertaining to disease presentation and progression werecollected. Results: The study included a total of 283 patients, of whom 76 were female and 206 were male. The median follow-up period for males was 99 days (IQR 38-283), while for females, it was 126 days (IQR 44-291). A higher prevalence of cardiovascular disease was observed in males (p=0.002). Females frequently experienced a loss of smell (p=0.021), whereas males commonly exhibited fever (p=0.031). Levels of ALT and gamma-glutamyl transferase were significantly elevated in males (p=0.008 and 0.004, respectively). Although there was a trend towards increased mortality in males, it did not reach statistical significance. Conclusion: This study is the first attempt to investigate gender differences in COVID-19 among liver transplant recipients. Our findings highlight the need for a comprehensive and personalised approach to treating this patient population and underscore the importance of further elucidating the disease presentation in these individuals.

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Kassas ME, Alboraie M, Balakosy AA, Abdeen N, Afify S, Abdalgaber M, et al. Liver transplantation in the era of COVID-19. Arab J Gastroenterol, 2020;21(2):69–75. https://doi.org/10.1016%2Fj.ajg.2020.04.019

Loinaz-Segurola C, Marcacuzco-Quinto A, Fernández-Ruiz M. Coronavirus disease 2019 in liver transplant patients: Clinical and therapeutic aspects. World Journal of Hepatology. 2021;13(10):1299–315. https://doi.org/10.4254%2Fwjh.v13.i10.1299

Maira TD, Berenguer M. COVID-19 and liver transplantation. Nat Rev Gastroenterol Hepatol. 2020;17(9):526–8. https://doi.org/10.1038/s41575-020-0347-z

Phipps MM, Verna EC. Coronavirus Disease 2019 and Liver Transplantation: Lessons from the First Year of the Pandemic. Liver Transpl. 2021;27(9):1312–25. https://doi.org/10.1002/lt.26194

Sahin TT, Akbulut S, Yilmaz S. COVID-19 pandemic: Its impact on liver disease and liver transplantation. World J Gastroenterol. 2020;26(22):2987–99. https://doi.org/10.3748%2Fwjg.v26.i22.2987

Kates OS, Haydel BM, Florman SS, Rana MM, Chaudhry ZS, Ramesh MS, et al. COVID-19 in solid organ transplant: A multi-center cohort study. Clin Infect Dis. 2020. https://doi.org/10.1093%2Fcid%2Fciaa1097

Pereira MR, Mohan S, Cohen DJ, Husain SA, Dube GK, Ratner LE, et al. COVID-19 in solid organ transplant recipients: Initial report from the US epicenter. Am J Transplant. 2020;20(7):1800–8. https://doi.org/10.1111/ajt.15941

Belli LS, Fondevila C, Cortesi PA, Conti S, Karam V, Adam R, et al. Protective Role of Tacrolimus, Deleterious Role of Age and Comorbidities in Liver Transplant Recipients With Covid-19: Results From the ELITA/ELTR Multi-center European Study. Gastroenterology. 2021;160(4):1151-1163.e3. https://doi.org/10.1053/j.gastro.2020.11.045

Belli LS, Duvoux C, Karam V, Adam R, Cuervas-Mons V, Pasulo L, et al. COVID-19 in liver transplant recipients: preliminary data from the ELITA/ELTR registry. The Lancet Gastroenterology & Hepatology. 2020;5(8):724–5. https://doi.org/10.1016/S2468-1253(20)30183-7

Coll E, Fernández-Ruiz M, Padilla M, Moreso F, Hernández-Vicente A, Yañez Í, et al. COVID-19 in Solid Organ Transplant Recipients in Spain Throughout 2020: Catching the Wave? Transplantation. 2021;105(10):2146–55. https://doi.org/10.1097/tp.0000000000003873

Coll E, Fernández-Ruiz M, Sánchez-Álvarez JE, Martínez-Fernández JR, Crespo M, Gayoso J, et al. COVID-19 in transplant recipients: The Spanish experience. Am J Transplant. 2021;21(5):1825–37. https://doi.org/10.1111/ajt.16369

Dumortier J, Duvoux C, Roux O, Altieri M, Barraud H, Besch C, et al. Covid-19 in liver transplant recipients: the French SOT COVID registry. Clin Res Hepatol Gastroenterol. 2021;45(4):101639. https://doi.org/10.1016/j.clinre.2021.101639

Miarons M, Larrosa-García M, García-García S, Los-Arcos I, Moreso F, Berastegui C, et al. COVID-19 in Solid Organ Transplantation: A Matched Retrospective Cohort Study and Evaluation of Immunosuppression Management. Transplantation. 2021;105(1):138–50. https://doi.org/10.1097/TP.0000000000003460

Webb GJ, Marjot T, Cook JA, Aloman C, Armstrong MJ, Brenner EJ, et al. Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study. The Lancet Gastroenterology & Hepatology. 2020;5(11):1008–16. https://doi.org/10.1016/S2468-1253(20)30271-5

Kulkarni AV, Tevethia HV, Premkumar M, Arab JP, Candia R, Kumar K, et al. Impact of COVID-19 on liver transplant recipients-A systematic review and meta-analysis. EClinicalMedicine. 2021;38:101025. https://doi.org/10.1016/j.eclinm.2021.101025

Mansoor E, Perez A, Abou-Saleh M, Sclair SN, Cohen S, Cooper GS, et al. Clinical Characteristics, Hospitalization, and Mortality Rates of Coronavirus Disease 2019 Among Liver Transplant Patients in the United States: A Multicenter Research Network Study. Gastroenterology. 2021;160(1):459-462.e1. https://doi.org/10.1053/j.gastro.2020.09.033

Ritchie H, Mathieu E, Rodés-Guirao L, Appel C, Giattino C, Ortiz-Ospina E, et al. Coronavirus Pandemic (COVID-19). 2020. Disponível em: https://ourworldindata.org/coronavirus

Rabinowich L, Grupper A, Baruch R, Ben-Yehoyada M, Halperin T, Turner D, et al. Low immunogenicity to SARS-CoV-2 vaccination among liver transplant recipients. J Hepatol. 2021;75(2):435–8. https://doi.org/10.1016/j.jhep.2021.04.020

Toniutto P, Falleti E, Cmet S, Cussigh A, Veneto L, Bitetto D, et al. Past COVID-19 and immunosuppressive regimens affect the long-term response to anti-SARS-CoV-2 vaccination in liver transplant recipients. J Hepatol. 2022;77(1):152–62. https://doi.org/10.1016/j.jhep.2022.02.015

Hardgrave H, Wells A, Nigh J, Klutts G, Krinock D, Osborn T, et al. COVID-19 Mortality in Vaccinated vs. Unvaccinated Liver & Kidney Transplant Recipients: A Single-Center United States Propensity Score Matching Study on Historical Data. Nato Adv Sci Inst Se. 2022;10(11):1921. https://doi.org/10.3390/vaccines10111921

Ma E, Ai J, Zhang Y, Zheng J, Gao X, Xu J, et al. Omicron infections profile and vaccination status among 1881 liver transplant recipients: a multi-centre retrospective cohort. Emerg Microbes Infec. 2022;11(1):2636–44. https://doi.org/10.1080%2F22221751.2022.2136535

Hamm SR, Rezahosseini O, Møller DL, Loft JA, Poulsen JR, Knudsen JD, et al. Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark. Am J Transplant. 2022;22(11):2637–50. https://doi.org/10.1111/ajt.17141

Su YJ, Kuo KC, Wang TW, Chang CW. Gender-based differences in COVID-19. New Microbes New Infect. 2021;42:100905. https://doi.org/10.1016/j.nmni.2021.100905

Ahmed MM, Sayed AM, Abd DE, Fares S, Said MSM, Ebrahim EES. Gender Difference in Perceived Symptoms and Laboratory Investigations in Suspected and Confirmed COVID-19 Cases: A Retrospective Study. J Prim Care Community Heal. 2021;12:215013272110397. https://doi.org/10.1177/21501327211039718

Ten-Caten F, Gonzalez-Dias P, Castro Í, Ogava RLT, Giddaluru J, Silva JCS, et al. In-depth Analysis of Laboratory Parameters Reveals the Interplay Between Sex, Age and Systemic Inflammation in Individuals with COVID-19. Int J Infect Dis Ijid Official Publ Int Soc Infect Dis. 2021;105:579–87. https://doi.org/10.1016/j.ijid.2021.03.016

Colmenero J, Rodríguez-Perálvarez M, Salcedo M, Arias-Milla A, Muñoz-Serrano A, Graus J, et al. Epidemiological pattern, incidence, and outcomes of COVID-19 in liver transplant patients. J Hepatol. 2021;74(1):148–55. https://doi.org/10.1016/j.jhep.2020.07.040

Liu H, He X, Wang Y, Zhou S, Zhang D, Zhu J, et al. Management of COVID-19 in patients after liver transplantation: Beijing working party for liver transplantation. Hepatol Int. 2020;14(4):432–6. https://doi.org/10.1007/s12072-020-10043-z

Hou Y, Zhou Y, Gack MU, Lathia JD, Kallianpur A, Mehra R, et al. Multimodal single-cell omics analysis identifies epithelium–immune cell interactions and immune vulnerability associated with sex differences in COVID-19. Signal Transduct Target Ther. 2021;6(1):292. https://doi.org/10.1038/s41392-021-00709-x

Rehman S, Ravinayagam V, Nahvi I, Aldossary H, Al-Shammari M, Amiri MSA, et al. Immunity, Sex Hormones, and Environmental Factors as Determinants of COVID-19 Disparity in Women. Front Immunol. 2021;12:680845. https://doi.org/10.3389/fimmu.2021.680845

Pereira MR, Arcasoy S, Farr MA, Mohan S, Emond JC, Tsapepas DS, et al. Outcomes of COVID-19 in solid organ transplant recipients: A matched cohort study. Transpl Infect Dis. 2021;23(4):e13637. https://doi.org/10.1097/tp.0000000000003670

Wang XW, Hu H, Xu ZY, Zhang GK, Yu QH, Yang HL, et al. Association of menopausal status with COVID-19 outcomes: a propensity score matching analysis. Biol Sex Differ. 2021;12(1):16. https://doi.org/10.1186/s13293-021-00363-6

Cai Z, Yang Y, Zhang J. Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis. Bmc Public Health. 2021;21(1):1505. https://doi.org/10.1186/s12889-021-11546-6

Gleeson LE, Roche HM, Sheedy FJ. Obesity, COVID-19 and innate immunometabolism. Brit J Nutr. 2020;125(6):628–32. https://doi.org/10.1017%2FS0007114520003529

Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. Bmc Infect Dis. 2021;21(1):855. https://doi.org/10.1186/s12879-021-06536-3

Publicado

2023-09-30

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Ataide, E. C., Riccetto, E., Genzini, T., Santos, R. G., Moreira, L. F. P., Pinto, L. C. M., Stucchi, R. S. B., Perales, S. R., Zanaga, L., Silva, R. F. da, Silva, R. C. M. F. da, Haddad, L., D´’Albuquerque, L. A. C., Almeida, M. D. de, Watanabe, A., Peixoto, G. S., Melo, C. M. L. de, Ferreira, R., Tefilli, N. L., Halpern, M., Godoy, M. S., Nogara, M., Marcelo Padilla Mancero, J., Noujaim, H. M., Garcia, J. H. P., Rangel, E. B., & Boin, I. de F. S. F. (2023). Gender Differences in COVID-19 Among Liver Transplant Recipients: Results from a Multicenter Brazilian Cohort. Brazilian Journal of Transplantation, 26. Recuperado a partir de https://bjt.emnuvens.com.br/revista/article/view/521

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