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

tetano

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



Affiliations

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.
 
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