Clinical Characteristics and Outcomes of Liver Transplantation Recipients With COVID-19 Pneumonia.

Abstract

BACKGROUND:

We aimed to evaluate the clinical characteristics and outcomes of mild-severe COVID-19 pneumonia cases in liver transplant (LT) recipients.

METHODS:

Ten LT recipients diagnosed as having COVID-19 pneumonia in a 6-month period in our transplantation center were included. Demographic and medical data of the recipients were retrospectively collected; clinical courses, treatment responses, and outcomes were evaluated.

RESULTS:

Ten LT recipients were male, had a median age of 57 years (min-max, 36-69 years; interquartile range [IQR], 13 years), and had right lobe from living donor LT performed in a median of 11 months (min-max, 1-72 months; IQR, 12 months). Five patients had severe pneumonia, and the remaining patients had mild/moderate pneumonia. The most frequent symptoms were fever (90%) and cough (70%). Favipiravir, enoxaparin sodium, and corticosteroid were initiated at the time of the diagnosis; immunosuppressive drug doses were reduced or discontinued in 3 cases. Lymphopenia median: 510/mL (min-max, 90-1400 mL; IQR, 610 mL), increased levels of C-reactive protein median: 4.72 (min-max, 0.31-23.4; IQR, 8.5), and ferritin median: 641 (min-max, 40 to ≥ 1650; IQR, 1108) were frequent. Four patients required antibacterial treatments because of emerging bacterial pneumonia and/or sepsis. All patients were hospitalized for a median of 10 days. One patient with sepsis died on the 26th day after intensive care unit admission, and the remaining 9 survived. No further complication was recorded for 1-month follow-up.

CONCLUSIONS:

Commencing favipiravir, enoxaparin sodium, and corticosteroid treatments; close follow-up of the developing complications; the temporary reduction or cessation of immunosuppression; a multidisciplinary approach; early awareness of the bacterial infections; and the initiation appropriate antibiotic treatments can contribute to success.

• Authors: Adem Kose, Sibel Altunisik Toplu, Murat Yalcinsoy, Yusuf Yakupogullari, Baris Otlu, Emrah Otan, Cemalettin Aydin, Sezai Yilmaz, Yasar Bayindir
• Journal: Transplantation proceedings (Transplant Proc) Vol. 53 Issue 8 Pg. 2481-2489 (Oct 2021) ISSN: 1873-2623 [Electronic] United States
• PMID: 34261580 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• COVID-19 (complications)
• COVID-19 Testing
• Humans
• Liver Transplantation
• Male
• Middle Aged
• Retrospective Studies
• Transplant Recipients
• COVID-19 Drug Treatment