World J Hepatol . Severe COVID-19 after liver transplantation, surviving the pitfalls of learning on-the-go: Three case reports

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World J Hepatol


. 2020 Oct 27;12(10):870-879.
doi: 10.4254/wjh.v12.i10.870.
Severe COVID-19 after liver transplantation, surviving the pitfalls of learning on-the-go: Three case reports


Felipe Alconchel ¹ , Pedro A Cascales-Campos ¹ , Jose A Pons ² , Mar?a Mart?nez ² , Josefa Valiente-Campos ¹ , Urszula Gajownik ² , Mar?a L Ortiz ² , Laura Mart?nez-Alarc?n ¹ , Pascual Parrilla ¹ , Ricardo Robles ¹ , Francisco S?nchez-Bueno ¹ , Santiago Moreno ³ , Pablo Ram?rez ¹



Affiliations

• PMID: 33200024
• PMCID: PMC7643211
• DOI: 10.4254/wjh.v12.i10.870

Abstract

Background: The novel coronavirus 2019 (COVID-19) pandemic has dramatically transformed the care of the liver transplant patient. In patients who are immunosuppressed and with multiple comorbidities, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with increased severity and mortality. The main objective of this report is to communicate our experience in the therapeutic management of SARS-CoV-2 infection in 3 liver transplant patients. Secondly, we stress the management and investigation of the contagious spreading into a liver transplant ward.
Case summary: The patients were two women (aged 61 years and 62 years) and one man (aged 68 years), all of them having recently received a liver transplant. All three patients required intensive care unit admission and invasive mechanical ventilation. Two of them progressed severely until death. The other one, who received tocilizumab, had a good recovery. In the outbreak, the wife of one of the patients and four healthcare professionals involved in their care were also infected.
Conclusion: We illustrate in detail the evolution of a nosocomial COVID-19 outbreak in a liver transplant ward. We believe that these findings will contribute to a better understanding of the natural history of the disease and will improve the treatment of the liver transplant patient with COVID-19.

Keywords: COVID-19; Case report; Cross infection; Liver transplantation; Nosocomial infection; SARS-CoV-2.