tetano
Editor, Senior Moderator
Transpl Infect Dis
. 2020 Jun 20;e13372.
doi: 10.1111/tid.13372. Online ahead of print.
Varied Clinical Presentation and Outcome of SARS-CoV-2 Infection in Liver Transplant Recipients: Initial Experience at a Single Center in Madrid, Spain
Carmelo Loinaz[SUP] 1 [/SUP], Alberto Marcacuzco[SUP] 1 [/SUP], Mario Fern?ndez-Ruiz[SUP] 2 [/SUP], Oscar Caso[SUP] 1 [/SUP], F?lix Cambra[SUP] 1 [/SUP], Rafael San Juan[SUP] 2 [/SUP], Iago Justo[SUP] 1 [/SUP], Jorge Calvo[SUP] 1 [/SUP], Alvaro Garc?a-Sesma[SUP] 1 [/SUP], Alejandro Manrique[SUP] 1 [/SUP], Mar?a Asunci?n P?rez-Jacoiste As?n[SUP] 3 [/SUP], Mar?a Dolores Folgueira[SUP] 4 [/SUP], Jos? Mar?a Aguado[SUP] 2 [/SUP], Carlos Lumbreras[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Which are the consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection in liver transplant (LT) recipients?
Methods: We attempted to address this question by reviewing our single-center experience during the first two months of the pandemics at a high incidence area.
Results: Nineteen adult patients (5 females) were diagnosed by May 5th, 2020. Median age was 58 (range 55-72), and median follow-up since transplantation was 83 (range 20-183) months. Cough (84.2%), fever (57.9%) and dyspnea (47.4%) were the most common symptoms. Thirteen patients (68.4%) had pneumonia in X-ray/CT scan. Hydroxychloroquine was administered in 11 patients, associated with lopinavir/ritonavir and interferon β in 2 cases each. Immunomodulatory therapy with tocilizumab was used in 2 patients. Immunosuppression (IS) was halted in one patient, and modified in only other two due to potential drug interactions. Five (26.3%) patients were managed as outpatient. Two patients (10.5%) died, 10 (52.6%) were discharged home, and 2 (10.5%) were still hospitalized after a median follow-up of 41 days from the onset of symptoms. Baseline IS regimen remained unchanged in all surviving recipients, with good liver function.
Conclusions: Our preliminary experience shows a broad spectrum of disease severity in LT patients with COVID-19, with a favorable outcome in most of them without needing to modify baseline IS.
Keywords: COVID-19; SARS-CoV2; immunosuppression; liver transplant; prognosis.
. 2020 Jun 20;e13372.
doi: 10.1111/tid.13372. Online ahead of print.
Varied Clinical Presentation and Outcome of SARS-CoV-2 Infection in Liver Transplant Recipients: Initial Experience at a Single Center in Madrid, Spain
Carmelo Loinaz[SUP] 1 [/SUP], Alberto Marcacuzco[SUP] 1 [/SUP], Mario Fern?ndez-Ruiz[SUP] 2 [/SUP], Oscar Caso[SUP] 1 [/SUP], F?lix Cambra[SUP] 1 [/SUP], Rafael San Juan[SUP] 2 [/SUP], Iago Justo[SUP] 1 [/SUP], Jorge Calvo[SUP] 1 [/SUP], Alvaro Garc?a-Sesma[SUP] 1 [/SUP], Alejandro Manrique[SUP] 1 [/SUP], Mar?a Asunci?n P?rez-Jacoiste As?n[SUP] 3 [/SUP], Mar?a Dolores Folgueira[SUP] 4 [/SUP], Jos? Mar?a Aguado[SUP] 2 [/SUP], Carlos Lumbreras[SUP] 3 [/SUP]
Affiliations
- PMID: 32562561
- DOI: 10.1111/tid.13372
Abstract
Background: Which are the consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection in liver transplant (LT) recipients?
Methods: We attempted to address this question by reviewing our single-center experience during the first two months of the pandemics at a high incidence area.
Results: Nineteen adult patients (5 females) were diagnosed by May 5th, 2020. Median age was 58 (range 55-72), and median follow-up since transplantation was 83 (range 20-183) months. Cough (84.2%), fever (57.9%) and dyspnea (47.4%) were the most common symptoms. Thirteen patients (68.4%) had pneumonia in X-ray/CT scan. Hydroxychloroquine was administered in 11 patients, associated with lopinavir/ritonavir and interferon β in 2 cases each. Immunomodulatory therapy with tocilizumab was used in 2 patients. Immunosuppression (IS) was halted in one patient, and modified in only other two due to potential drug interactions. Five (26.3%) patients were managed as outpatient. Two patients (10.5%) died, 10 (52.6%) were discharged home, and 2 (10.5%) were still hospitalized after a median follow-up of 41 days from the onset of symptoms. Baseline IS regimen remained unchanged in all surviving recipients, with good liver function.
Conclusions: Our preliminary experience shows a broad spectrum of disease severity in LT patients with COVID-19, with a favorable outcome in most of them without needing to modify baseline IS.
Keywords: COVID-19; SARS-CoV2; immunosuppression; liver transplant; prognosis.