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CASE REPORT
COVID-19 in Liver Transplant Recipients - A Series with Successful Recovery
Ashok Choudhury1, Golamari Srinivasa Reddy1, Shantan Venishetty1, Viniyendra Pamecha2, Saggere Muralikrishna Shasthry1, Arvind Tomar3, Lalita Gauri Mitra4, Venkata Siva Tez Prasad5, Rajendra Prasad Mathur5, Debajyoti Bhattacharya3 and Shiv Kumar Sarin*,1
1 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
2 Department of HPB Surgery and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
3 Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
4 Department of Critical Care Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
5 Department of Nephrology, Institute of Liver and Biliary Sciences, New Delhi, India
*Correspondence to: Shiv Kumar Sarin, Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi 110070, India. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Journal of Clinical and Translational Hepatology 2020;8(4):467-473 DOI: 10.14218/JCTH.2020.00061
Received: July 7, 2020 Accepted: August 29, 2020 Published online: October 10, 2020
Abstract
The severe acute respiratory syndrome corona virus-2 (referred to as SARS CoV2) pandemic had a great impact on public life in general as well as on populations with pre-existing disease and co-morbidities. Liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosuppression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/o convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anticoagulation, consideration of repurposed drugs (i.e. teicoplanin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.
Keywords
Liver transplant, COVID-19, SARS-CoV-2, Liver injury, Remdesivir, Convalescent plasma
Journal of Clinical and Translational Hepatology 2020 vol. 8, 467-473 [ Html ] [ PDF Full-text ]
© The Authors 2020. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
