From the Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2022 May;20(Suppl 3):66-71. doi: 10.6002/ect.PediatricSymp2022.O22.
Several studies suggest that chronic immunosuppression in pediatric liver transplant patients may affect the severity and mortality rates of SARS-CoV-2 infection.
We assessed a total of 118 pediatric liver transplant recipients for SARS-CoV-2 infection, aged 1 to 18 years, followed between March 2019 and January 2022. We compared the clinical characteristics and outcomes of SARS-CoV-2 infection in pediatric liver transplant patients to 187 non-liver transplant pediatric patients with SARSCoV-2 infection who had been diagnosed at our institution between March 15, 2020, and December 31, 2020. Demographic data, clinical features, and laboratory findings from the patients were retrospectively collected from hospital reports and telephone inquiries.
A total of 20 liver transplant patients with SARS-CoV-2 infection were identified. Median age of liver transplant recipients with SARS-CoV-2 infection was higher than non-liver transplant pediatric patients with SARS-CoV-2 (14.8 [range, 7-16] vs 6.8 [range, 2-14] years; P = .016). There were no significant differences in mild and moderate disease courses of SARS-CoV-2 infection between liver transplant recipients and non-liver transplant pediatric patients (18 [90.0%] vs 133 [71.1%] patients [P = .188] and 2 [10%] vs 49 [26.2%] patients [P = .118], respectively). Fever was less frequently observed in liver transplant patients with SARS-CoV-2 infection compared with non-liver transplant patients (55.0% vs 80.2%; P = .015). We found no intergroup differences in sex (P = .342), hospitalization rate (P = .161), and overall clinical presentation.
Despite the immunosuppression regimens, liver transplant patients in our series survived SARS-CoV-2 infection without serious sequelae and without graft rejection. Overall, liver transplant and non-liver transplant pediatric patients with SARSCoV-2 infection experienced a mild disease course.
多项研究表明，儿科肝移植患者的慢性免疫抑制可能会影响 SARS-CoV-2 感染的严重程度和死亡率。
我们评估了总共 118 名年龄在 1 至 18 岁之间的接受过肝移植的儿科肝移植患者，这些患者在 2019 年 3 月至 2022 年 1 月期间接受了随访。我们将肝移植患者的 SARS-CoV-2 感染的临床特征和结局与 187 名在我们机构诊断出 SARSCoV-2 感染的非肝移植儿科患者进行了比较，这些患者的诊断时间为 2020 年 3 月 15 日至 2020 年 12 月 31 日。从医院报告和电话查询中回顾性收集患者的人口统计学数据、临床特征和实验室结果。
共发现 20 例肝移植患者感染 SARS-CoV-2。感染 SARS-CoV-2 的肝移植受者的中位年龄高于非肝移植儿科患者（14.8[范围，7-16] vs. 6.8[范围，2-14]岁；P =.016）。肝移植受者与非肝移植儿科患者的 SARS-CoV-2 感染轻、中度病程无显著差异（18[90.0%] vs. 133[71.1%]患者[P =.188]和 2[10%] vs. 49[26.2%]患者[P =.118]）。感染 SARS-CoV-2 的肝移植患者发热的频率低于非肝移植患者（55.0% vs. 80.2%；P =.015）。我们未发现两组间在性别（P =.342）、住院率（P =.161）和总体临床表现方面存在差异。
尽管存在免疫抑制方案，但我们研究中的肝移植患者在没有严重后遗症和移植物排斥的情况下存活了 SARS-CoV-2 感染。总体而言，肝移植和非肝移植儿科患者的 SARSCoV-2 感染呈轻度病程。
