Increased risk of death due to severe acute coronavirus (SARS-CoV2) syndrome is connected with advanced ageing and co-morbid conditions in people suffering from native liver (LD) and liver transplantation. The study aims to report results for LD and LT children registered in the SARS-CoV2 SPLIT/NASPGHAN registry. Data from 91 patients <21 years with laboratory-confirmed SARS-CoV2 disease were gathered in this multi-center observational cohort trial. In the case of LD, admission and paediatric intensive care (PICU) was more likely to be required in patients with LD. Seven patients with LD were required to be ventilated mechanically and 2 died, with no patients killed or requiring MV in the LT cohort. Four LD patients with PALF, 2 patients with concomitant MIS (Children’s Inflammatory Syndrome), all recovered without LT. Patients with MIS-C. In MIS-C alone, two LD patients and one patient were killed. Bivariable analysis in logistic regression indicated that NAFLD and LD patients were more likely to be seriously ill (PICU, vasopressor support, MV, renal replacement therapy or death).

Despite the immunosuppressive load, LT recipients had a decreased risk of severe SARS-CoV2 infection. Patients with NAFLD who reported to the registry had a greater risk of severe SARS-CoV2 illness. Future controlled studies are required to assess successful treatments and further stratify LD and LT patients infected with SARS-CoV2.