COVID-19 in a liver transplant recipient: Could iatrogenic immunosuppression have prevented severe pneumonia? A case report

被引:10
|
作者
Sessa, Anna [1 ,2 ]
Mazzola, Alessandra [2 ,3 ]
Lim, Chetana [4 ]
Atif, Mohammed [5 ]
Pappatella, Juliana [2 ,6 ]
Pourcher, Valerie [7 ]
Scatton, Olivier [3 ,4 ]
Conti, Filomena [2 ,3 ,8 ]
机构
[1] Univ Naples Federico II, Dept Hepatol & Gastroenterol, I-80131 Naples, Italy
[2] Hop La Pitie Salpetriere, AP HP, Unite Med Transplantat Hepat, Blvd Hop 47-83, F-75013 Paris, France
[3] Sorbonne Univ, INSERM, Ctr Rech St Antoine CRSA, F-75013 Paris, France
[4] Hop La Pitie Salpetriere, AP HP, Unite Chirurg Hepatobiliaire & Transplantat Hepat, F-75013 Paris, France
[5] Hop La Pitie Salpetriere, AP HP, INSERM, Ctr Immunol & Malad Infect,U1135, F-75013 Paris, France
[6] Hosp Felicio Rocho, BR-9530 Barro Preto, Brazil
[7] Hop La Pitie Salpetriere, AP HP, Serv Malad Infect, F-75013 Paris, France
[8] Sorbonne Univ, INSERM, Inst Cardiometab & Nutr ICAN, F-75013 Paris, France
关键词
Liver transplantation; COVID-19; Immunosuppression; Gastrointestinal symptom; Infection; Case report;
D O I
10.3748/wjg.v26.i44.7076
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND Coronavirus disease (COVID) is a new and highly contagious infectious disease caused by the coronavirus (COVID-19 or severe acute respiratory syndrome coronavirus 2). There is limited data regarding the incidence and management of COVID-19 in immunocompromised patients' post-transplantation. In the pre-COVID-19 era, these patients were already at an increased risk of developing opportunistic infections. These often manifested with atypical symptoms. CASE SUMMARY We report another case of uneventful COVID-19 pneumonia in a 58-year old male who was 18 mo' post liver transplantation. He received tacrolimus monotherapy since July 2019. The clinical manifestations included only epigastric pain radiating to the right hypochondrium, nausea and vomiting. He had no fevers, cough, shortness of breath, anosmia or dysgeusia even if the chest computed tomography scan revealed an extension of the multiple patchy ground-glass density shadows to the upper lobe of the left lung too. He was hospitalised and received a course of oral chloroquine (200 mg x 3 per day) for a period of 10 d. Interestingly, the COVID 19 infection was uneventful though there were no modifications to his tacrolimus dosing. He was successfully discharged. We performed subsequent follow-up via telemedicine. CONCLUSION In light of the current pandemic, it is even more important to identify how the liver recipient's patients present and are managed, especially for immunosuppression treatment.
引用
收藏
页码:7076 / 7084
页数:10
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