COVID-19 pandemic: Its impact on liver disease and liver transplantation

Table 1 The summary of the clinical studies about acute liver injury in coronavirus infectious disease-2019

Ref.	Total patients	No. of ALI, n (%)	No. of severe disease among ALI, n (%)	Number of dismal prognosis among ALI, n (%)
Zhou et al[4]	191	59 (38.8)	NS	26 (44.1)
Huang et al[24]	41	15 (36.6)	8 (53.3)	NS
Guan et al[41]	1099	326 (29.7)	94 (28.8)	46 (14.1)
Hu et al[43]	323	265 (82)	134 (50.6)	58 (21.9)
Zhang et al[45]	115	28 (24.3)	20 (71.4)	NS
Yang et al[44]	149	45 (30.2)	NS	NS
Fu et al[46]	350	101 (28.8)	NS	14 (13.9)
Cai et al[47]	298	44 (14.7)	21 (47.7)	NS
Cao et al[48]1	199	120 (60.3)	NS	NS
Shi et al[49]	81	43 (53.1)	26 (83.7)	NS
Omrani-Nava et al[50]	93	27 (29.2)	NS	NS

It was considered acute liver injury if the patients had elevated alanine aminotransferase, aspartate aminotransferase, or both or if acute liver injury is reported by the authors.

¹All were severe cases. ALI: Acute liver injury; No.: Number of individuals dismal prognosis: progression of the disease despite suitable therapy of occurrence of mortality in the patients; NS: Not specified.

Table 2 The summary of the clinical studies about coronavirus infectious disease-2019 infection in patients with pre-existing liver disease

Ref.	Total number of Patients	Number of cirrhosis, n (%)	Number severe disease among cirrhosis, n (%)	Number of dismal prognosis among cirrhosis, n (%)
Huang et al[24]	41	1 (2.4)	0	0
Guan et al[41]	1099	23 (2.1)	1 (4.3)	1 (4.3)
Hu et al[43]	323	3 (0.9)	0	0
Cai et al[47]	298	28 (9.4)	8 (28.6)	NS
Shi et al[49]	81	7 (8.9)	5 (71.4)	NS
Luo et al[61]	403	25 (6.2)	NS	9 (36)
Luo et al[62]	298	16 (5.4)	NS	5 (31.3)

Dismal prognosis states death (n = 14) or progression of the disease (n = 1) despite suitable treatment. NS: Not specified.

Table 3 The summary of the reported case series of coronavirus infectious disease-2019 in liver transplant recipients

Ref.	Total No. of transplants	Age group	Date of LT procedure	No. of COVID-19 cases, n (%)	No. of deaths, n (%)
D’Antiga[70]	7001	Pediatric	NS	3 (0.04)	0
Bhoori et al[71]	151	Adult	111 (> 10 yr) vs 40 (< 2 yr)	6 (3.9)	3 (1.9)2

¹D’Antiga[70] reported the total number of pediatric patients with the liver disease treated in their institute. Seven hundred patients include 200 liver transplant recipients as well. They have not specified the 3 patients with coronavirus infectious disease-2019 (COVID-19); whether they are a transplant recipient or not is unknown.

²The three transplant recipients that died due to COVID-19 were from the long-term recipient group. The graft types were not specified in both studies. No.: The number of affected individuals; COVID-19: Coronavirus infectious disease-2019.

Table 4 Summary of single case reports of coronavirus infectious disease-2019 in liver transplant recipients

Ref.	Sex	Age	LT date	Type of LT	Etiology	Duration before diagnosis (d)	Severity of COVID-19	Outcome	Time to outcome (d)
Huang et al[72]	M	59	2017	NS	HBV+HCC	3	Severe	Died	45
Liu et al[73]	M	50	2017	DDLT	HBV	6	Severe	Recovered	38
Qin et al[74]	M	37	2019	NS	HBV+HCC	9	Mild	Recovered	53
Lagana et al[75]	F	0.5	2020	LDLT	Biliary atresia	01	Severe	Recovered	NS2

¹Lagana and colleagues have reported a pediatric living donor-recipient who contracted the virus from the donor (mother of the patient). The donor was tested positive on post-transplant day 2 and the patient was diagnosed on postoperative day 4 due to difficulty in breathing.

²The patient was still hospitalized with very minor respiratory symptoms. LT: Liver transplant; DDLT: Deceased donor liver transplant; LDLT: living donor liver transplantation; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; M: Male; F: Female; NS: Not specified; COVID-19: Coronavirus infectious disease-2019.