Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Ethiop J Health Sci. 2021 Mar;31(2):429-438. doi: 10.4314/ejhs.v31i2.26.
This systematic review is conducted to explore available information on clinical presentations, laboratory finding and outcomes of SARS-COV-2 in liver transplant patients.
We searched four databases for relevant terms related to COVID-19 and liver transplantation and collected both case reports and case series on liver transplantation published up to the end of September 2020.
After initial screening of irrelevant articles, 25 studies were included and analyzed in this review. Among the 59 patients included, 78.3% were over 50 years old, and 71.6% were males. The majority of patients (93.3%) were hospitalized. The most common presenting symptoms were fever (72.9%) followed by dyspnea and cough (54.2%). The majority of patients revealed a high level of CRP (64.3%). Moreover, high level ALT, AST and ALP were reported in 64.3, 37.5, 30.5 and 22.2% of patients. A total, 9(15.3%), of cases died as a result of complications of COVID-19. Chest radiographs were reported in 72.9%(43/59) of cases that 94% demonstrated radiologic evidence of abnormality.
The results demonstrated that the most prevalent symptoms and signs were fever, dyspnea and cough. Moreover, most patients were males and hospitalized. The rate of mortality and high level of CRP, ALT/AST and ALP is similar within the non-immune suppressed and general population. However, early detection of high level of serum CRP, ALT/AST and ALP combined with a clinical COVID-19 symptom and finding of CT scan may be used as an index for the presence and severity of the disease.
本系统评价旨在探讨 SARS-CoV-2 在肝移植患者中的临床表现、实验室检查结果和转归的现有信息。
我们在四个数据库中检索了与 COVID-19 和肝移植相关的术语，并收集了截至 2020 年 9 月底发表的有关肝移植的病例报告和病例系列。
经过对不相关文章的初步筛选，本综述纳入了 25 项研究进行分析。在纳入的 59 名患者中，78.3%的患者年龄超过 50 岁，71.6%的患者为男性。大多数患者（93.3%）住院。最常见的症状是发热（72.9%），其次是呼吸困难和咳嗽（54.2%）。大多数患者的 CRP 水平较高（64.3%）。此外，64.3%、37.5%、30.5%和 22.2%的患者报告 ALT、AST 和 ALP 水平较高。共有 9 例（15.3%）患者因 COVID-19 并发症而死亡。在 72.9%（43/59）的病例中报告了胸部 X 线检查，其中 94%显示放射学异常证据。
结果表明，最常见的症状和体征是发热、呼吸困难和咳嗽。此外，大多数患者为男性且住院。死亡率以及 CRP、ALT/AST 和 ALP 水平较高的情况在非免疫抑制和一般人群中相似。然而，早期检测血清 CRP、ALT/AST 和 ALP 水平升高并结合 COVID-19 临床症状和 CT 扫描结果可能作为疾病存在和严重程度的指标。
