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

• 作者: Felipe Alconchel Francisco Sánchez-Bueno Jose A Pons Josefa Valiente-Campos Laura Martínez-Alarcón María L Ortiz María Martínez Pablo Ramírez Pascual Parrilla Pedro A Cascales-Campos Ricardo Robles Santiago Moreno Urszula Gajownik
• 来源期刊: 世界肝病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Liver transplantation COVID-19 SARS-CoV-2 Cross infection Nosocomial infection Case report
• 年，卷（期）: 2020,（10）
• 页码范围: 870-879
• 页数: 10页
• 分类号: R57

摘要

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.