Abstract
Background: Coronavirus disease 2019 (COVID-19) has affected all facets of life and continues to cripple nations. COVID-19 has taken the lives of more than 2.1 million people worldwide, with a global mortality rate of 2.2%. Current COVID-19 treatment options include supportive respiratory care, parenteral corticosteroids, and remdesivir. Although COVID-19 is associated with increased risk of morbidity and mortality in patients with comorbidities, the vulnerability, clinical course, optimal management, and prognosis of COVID-19 infection in patients with organ transplants has not been well described in the literature. The treatment of COVID-19 differs based on the organ(s) transplanted. Preliminary data suggested that liver transplant patients with COVID-19 did not have higher mortality rates than untransplanted COVID-19 patients. Table 1 depicts a compiled list of current published data on COVID-19 liver transplant patients. Most of these studies included both recent and old liver transplant patients. No distinction was made for early liver transplant patients who contract COVID-19 within their posttransplant hospitalization course. This potential differentiation needs to be further explored. Here, we report 2 patients who underwent liver transplantation who acquired COVID-19 during their posttransplant recovery period in the hospital.
Case descriptions: Two patients who underwent liver transplant and contracted COVID-19 in the early posttransplant period and were treated with hydroxychloroquine, methylprednisolone, tocilizumab, and convalescent plasma. This article includes a description of their hospital course, including treatment and recovery.
Conclusion: The management of post-liver transplant patients with COVID-19 infection is complicated. Strict exposure precaution practice after organ transplantation is highly recommended. Widespread vaccination will help with prevention, but there will continue to be patients who contract COVID-19. Therefore, continued research into appropriate treatments is still relevant and critical. A temporary dose reduction of immunosuppression and continued administration of low-dose methylprednisolone, remdesivir, monoclonal antibodies, and convalescent plasma might be helpful in the management and recovery of severe COVID-19 pneumonia in post-liver transplant patients. Future studies and experiences from posttransplant patients are warranted to better delineate the clinical features and optimal management of COVID-19 infection in liver transplant recipients.
【초록키워드】 COVID-19, Methylprednisolone, Treatment, coronavirus disease, convalescent plasma, Coronavirus disease 2019, Severe COVID-19 pneumonia, Corticosteroids, COVID-19 pneumonia, vaccination, Hydroxychloroquine, Prognosis, Hospitalization, Tocilizumab, hospital, Infection, Comorbidities, Immunosuppression, Remdesivir, Organ transplant, monoclonal antibodies, Clinical features, Clinical course, COVID-19 infection, management, low-dose, vulnerability, morbidity, Research, Patient, Liver transplantation, morbidity and mortality, mortality rate, Critical, liver, patients, clinical feature, COVID-19 patients, liver transplant, organ transplantation, administration, life, Respiratory care, treatment of COVID-19, increased risk, recipients, two patients, help, table, Preliminary data, description, organ, organ transplants, MOST, Future, dose reduction, current, Course, described, affected, include, treated, Two patient, suggested, global mortality, patients with comorbidities, patients with COVID-19, 【제목키워드】 COVID-19, Transplant, recipient,