SARS-CoV-2 seroprevalence and clinical features of COVID-19 in a German liver transplant recipient cohort: a prospective serosurvey study.

Abstract: Introduction In liver transplant (LT) recipients with severe COVID-19 fatal outcome has been reported in a substantial subset of patients. Whether LT recipients are at increased risk for severe COVID-19 compared to the general population is controversial. Here we report the results of a SARS-CoV-2 serosurvey in a large LT recipient cohort. Material and methods 219 LT recipients were enrolled between May 5th, 2020 and August 6th, 2020 at the University Hospital. Serum blood samples were collected and tested for anti SARS-CoV-2 IgG. SARS-CoV-2 RNA was detected in nasopharyngeal swabs using RT-PCR. Results Taking into account known risk factors of arterial hypertension, obesity, diabetes or leukopenia, LT recipients a priori represented a high-risk cohort for severe COVID-19 with 101/219 (46.1 %) presenting with more than 2 risk factors for severe COVID-19. Out of 219 LT recipients 8 (3.7%) were either tested positive for nasopharyngeal SARS-CoV-2 RNA or anti-SARS-CoV-2 serum IgG. 5/8 (62.5 %) did not show any clinical signs of infection, 3/8 (37.5%) had self-limited disease, none required hospitalization for COVID-19. 2/8 (25 %) had known exposure to infected health care personal as the possible source of infection. Conclusion In summary, LT recipients showed a SARS-CoV-2 seroconversion rate similar to the general population with a substantial percentage of unrecognized infections.