Successful Management of COVID-19 Infection in 2 Early Post-Liver Transplant Recipients.
Identifieur interne : 000090 ( Main/Corpus ); précédent : 000089; suivant : 000091Successful Management of COVID-19 Infection in 2 Early Post-Liver Transplant Recipients.
Auteurs : Miles Dale ; Hiroshi Sogawa ; Seyed Mohammad Seyedsaadat ; David C. Wolf ; Roxana Bodin ; Bernard Partiula ; Rajat Nog ; Rifat Latifi ; Devon John ; Gregory Veillette ; Thomas Diflo ; Seigo NishidaSource :
- Transplantation proceedings [ 1873-2623 ] ; 2021.
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.
DOI: 10.1016/j.transproceed.2021.03.010
PubMed: 33888342
PubMed Central: PMC7972672
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Electronic address: Miles.m.dale@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Sogawa, Hiroshi" sort="Sogawa, Hiroshi" uniqKey="Sogawa H" first="Hiroshi" last="Sogawa">Hiroshi Sogawa</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Seyedsaadat, Seyed Mohammad" sort="Seyedsaadat, Seyed Mohammad" uniqKey="Seyedsaadat S" first="Seyed Mohammad" last="Seyedsaadat">Seyed Mohammad Seyedsaadat</name><affiliation><nlm:affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Wolf, David C" sort="Wolf, David C" uniqKey="Wolf D" first="David C" last="Wolf">David C. Wolf</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Bodin, Roxana" sort="Bodin, Roxana" uniqKey="Bodin R" first="Roxana" last="Bodin">Roxana Bodin</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Partiula, Bernard" sort="Partiula, Bernard" uniqKey="Partiula B" first="Bernard" last="Partiula">Bernard Partiula</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Nog, Rajat" sort="Nog, Rajat" uniqKey="Nog R" first="Rajat" last="Nog">Rajat Nog</name><affiliation><nlm:affiliation>Transplant Infectious Disease, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Latifi, Rifat" sort="Latifi, Rifat" uniqKey="Latifi R" first="Rifat" last="Latifi">Rifat Latifi</name><affiliation><nlm:affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="John, Devon" sort="John, Devon" uniqKey="John D" first="Devon" last="John">Devon John</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Veillette, Gregory" sort="Veillette, Gregory" uniqKey="Veillette G" first="Gregory" last="Veillette">Gregory Veillette</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Diflo, Thomas" sort="Diflo, Thomas" uniqKey="Diflo T" first="Thomas" last="Diflo">Thomas Diflo</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Nishida, Seigo" sort="Nishida, Seigo" uniqKey="Nishida S" first="Seigo" last="Nishida">Seigo Nishida</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33888342</idno><idno type="pmid">33888342</idno><idno type="doi">10.1016/j.transproceed.2021.03.010</idno><idno type="pmc">PMC7972672</idno><idno type="wicri:Area/Main/Corpus">000090</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000090</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Successful Management of COVID-19 Infection in 2 Early Post-Liver Transplant Recipients.</title><author><name sortKey="Dale, Miles" sort="Dale, Miles" uniqKey="Dale M" first="Miles" last="Dale">Miles Dale</name><affiliation><nlm:affiliation>General Surgery, Westchester Medical Center, Valhalla, New York. Electronic address: Miles.m.dale@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Sogawa, Hiroshi" sort="Sogawa, Hiroshi" uniqKey="Sogawa H" first="Hiroshi" last="Sogawa">Hiroshi Sogawa</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Seyedsaadat, Seyed Mohammad" sort="Seyedsaadat, Seyed Mohammad" uniqKey="Seyedsaadat S" first="Seyed Mohammad" last="Seyedsaadat">Seyed Mohammad Seyedsaadat</name><affiliation><nlm:affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Wolf, David C" sort="Wolf, David C" uniqKey="Wolf D" first="David C" last="Wolf">David C. Wolf</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Bodin, Roxana" sort="Bodin, Roxana" uniqKey="Bodin R" first="Roxana" last="Bodin">Roxana Bodin</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Partiula, Bernard" sort="Partiula, Bernard" uniqKey="Partiula B" first="Bernard" last="Partiula">Bernard Partiula</name><affiliation><nlm:affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Nog, Rajat" sort="Nog, Rajat" uniqKey="Nog R" first="Rajat" last="Nog">Rajat Nog</name><affiliation><nlm:affiliation>Transplant Infectious Disease, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Latifi, Rifat" sort="Latifi, Rifat" uniqKey="Latifi R" first="Rifat" last="Latifi">Rifat Latifi</name><affiliation><nlm:affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="John, Devon" sort="John, Devon" uniqKey="John D" first="Devon" last="John">Devon John</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Veillette, Gregory" sort="Veillette, Gregory" uniqKey="Veillette G" first="Gregory" last="Veillette">Gregory Veillette</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Diflo, Thomas" sort="Diflo, Thomas" uniqKey="Diflo T" first="Thomas" last="Diflo">Thomas Diflo</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Nishida, Seigo" sort="Nishida, Seigo" uniqKey="Nishida S" first="Seigo" last="Nishida">Seigo Nishida</name><affiliation><nlm:affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Transplantation proceedings</title><idno type="eISSN">1873-2623</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CASE DESCRIPTIONS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33888342</PMID><DateRevised><Year>2021</Year><Month>04</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-2623</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Mar</Month><Day>19</Day></PubDate></JournalIssue><Title>Transplantation proceedings</Title><ISOAbbreviation>Transplant Proc</ISOAbbreviation></Journal><ArticleTitle>Successful Management of COVID-19 Infection in 2 Early Post-Liver Transplant Recipients.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0041-1345(21)00198-6</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.transproceed.2021.03.010</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText><AbstractText Label="CASE DESCRIPTIONS" NlmCategory="METHODS">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.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">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.</AbstractText><CopyrightInformation>Copyright © 2021 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dale</LastName><ForeName>Miles</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>General Surgery, Westchester Medical Center, Valhalla, New York. Electronic address: Miles.m.dale@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sogawa</LastName><ForeName>Hiroshi</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seyedsaadat</LastName><ForeName>Seyed Mohammad</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wolf</LastName><ForeName>David C</ForeName><Initials>DC</Initials><AffiliationInfo><Affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bodin</LastName><ForeName>Roxana</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Partiula</LastName><ForeName>Bernard</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Liver and Gastroenterology, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nog</LastName><ForeName>Rajat</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Transplant Infectious Disease, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Latifi</LastName><ForeName>Rifat</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>General Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>John</LastName><ForeName>Devon</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Veillette</LastName><ForeName>Gregory</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Diflo</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nishida</LastName><ForeName>Seigo</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Transplant Surgery, Westchester Medical Center, Valhalla, New York.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>03</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>United 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