Am J Transplant. Clinical Course of COVID-19 in a Liver Transplant Recipient on Hemodialysis and Response to Tocilizumab Therapy: A Case Report

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Am J Transplant. 2020 May 2. doi: 10.1111/ajt.15985. [Epub ahead of print]
Clinical Course of COVID-19 in a Liver Transplant Recipient on Hemodialysis and Response to Tocilizumab Therapy: A Case Report.


Hammami MB¹, Garibaldi B², Shah P², Liu G³, Jain T⁴, Chen PH¹, Kim AK¹, Avdic E⁵, Petty B⁶, Strout S⁵, Fine DM⁷, Niranjan-Azadi A³, Garneau WM³, Cameron AM⁸, Monroy Trujillo JM⁷, Gurakar A¹, Avery R⁹.

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Abstract

The novel coronavirus disease 2019 (COVID-19) is a highly infectious and rapidly spreading disease. There are limited published data on the epidemiology and outcomes of COVID-19 infection among organ transplant recipients. After initial flulike symptoms, progression to an inflammatory phase may occur, characterized by cytokine release rapidly leading to respiratory and multiorgan failure. We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab. We also highlight the role of lung ultrasonography in early diagnosis of the inflammatory phase of COVID-19. Future investigation of the effects of immunomodulators among transplant recipients with COVID-19 infection will be important.
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PMID:32359210DOI:10.1111/ajt.15985