Abstract
We present here the case of a 62-year-old man, who was referred to the emergency department with fever and cough for 3 days. He underwent liver transplantation 4 years earlier due to HCV and NASH-related cirrhosis with hepatocellular carcinoma. At admission he was in reduced general conditions. Nasopharyngeal smear specimen resulted positive for SARS-CoV-2 infection. Pulmonary low-dose CT-scan revealed bilateral subpleural ground-glass infiltrates. O2 saturation was 93%. A treatment with lopinavir/ritonavir and hydroxychloroquine twice daily was started. The patient received also cefepime and remained in isolation. Seven days later imaging showed a progression of the pulmonary infiltrates. Cefepime was replaced by meropenem. During the following 3 days the fever resolved, and the general conditions of the patient significantly improved. Consequently, treatment with lopinavir/ritonavir and hydroxychloroquine was stopped. The evolution of SARS-CoV-2 interstitial pneumonia in this immunosuppressed patient was moderate to severe and liver injury was not clinically significant. Despite its limitations, this case report confirm that the liver may be only mildly affected during SARS-CoV-2 infection, also in liver transplanted patients. Further studies are needed to assess whether the outcome of SARS-CoV-2 infection is worse in immunosuppressed patients than in the general population.
Keywords: COVID-19; Hydroxychloroquine; Immunosuppression; Lopinavir; Low-dose CT scan.
【저자키워드】 COVID-19, Hydroxychloroquine, Lopinavir, Immunosuppression, Low-dose CT scan., 【초록키워드】 Treatment, Lopinavir/ritonavir, Hydroxychloroquine, SARS-COV-2 infection, Lopinavir, Ritonavir, Immunosuppression, progression, outcome, cough, pulmonary, HCV, Case report, emergency department, cirrhosis, low-dose, CT scan, Fever, Patient, Liver transplantation, Isolation, Evolution of SARS-CoV-2, Liver injury, General population, interstitial pneumonia, Admission, liver, moderate, patients, CT-scan, immunosuppressed patients, Immunosuppressed, Hepatocellular carcinoma, referred to, moderate to severe, meropenem, cefepime, general condition, specimen, REPLACED BY, pulmonary infiltrates, positive, O2 Saturation, NASH, limitations, affected, significantly, the patient, remained, clinically, reduced, replaced, conditions, resolved, immunosuppressed patient, subpleural, 【제목키워드】 Characteristics, clinical, management, liver transplanted patient,