Successful treatment of severe COVID-19 pneumonia in a liver transplant recipient

Liu, Bin; Wang, Yangzhong; Zhao, Yuanyuan; Shi, Huibo; Zeng, Fanjun; Chen, Zhishui

doi:10.1111/ajt.15901

Cited by 79 publications

(70 citation statements)

References 10 publications

(9 reference statements)

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“…The characteristics of included trials were presented in Table 1 . A total of 269 patients from 47 studies [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 [95% CI, 42.49; 59.34], and 49% [95% CI, 0.33, 0.65] patients were female.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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Background The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality ( r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality ( r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.

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Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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“…coronaviruses, such as SARS and MERS epidemics [5]. In contrast, since its initial detection in Wuhan at the end of last year, at least 21 cases of COVID-19 disease in transplant patients have been reported [6][7][8][9][10][11][12][13][14][15][16][17]. To date these cases have primarily involved kidney, liver, bone marrow and cardiac allograft recipients whilst this case report describes two lung transplant recipients affected by COVID-19 pneumonia.…”

Section: Transplant Recipients Have Been Only Minimally Affected By Ementioning

confidence: 95%

COVID-19 pneumonia in lung transplant recipients: Report of 2 cases

Cozzi

Faccioli

Marinello

et al. 2020

American Journal of Transplantation

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A pneumonia of unknown origin, detected in Wuhan (China), was first reported to the World Health Organization (WHO) on December 31, 2019. On January 9, 2020, a new strain of coronavirus (SARS-CoV-2) was identified as the etiologic agent of this novel respiratory disease called COVID-19. Since then, the infection has spread in more than 200 countries, becoming pandemic in March 2020 with a total of 2 078 605 confirmed cases and 139 515 deaths according to the latest WHO report (April 17, 2020). 1 Italy was the first European country confronted with the COVID

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“…In our case story, the patient was continued in immunosuppressive therapy without any adjustments. On the contrary, among the rst case stories of SARS-CoV2 infected liver transplant recipients published, temporary withdrawal of tacrolimus and administration of methylprednisolone 40 mg/day in a patient with severe lymphopenia was the presented (12). We speculate that increased mortality rates seen among organ transplant recipients could be associated with a reduction of immunosuppressive therapy (3).…”

Section: Discussionmentioning

confidence: 99%

Recovery of moderate COVID-19 disease in a liver transplant recipient on continued immunosuppression

Mathiasen

Karlsen

Ott

et al. 2020

Preprint

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BackgroundThe global outbreak of severe acute respiratory syndrome coronavirus 2 has had an enormous impact on the world. It remains unclear to what extent liver transplant recipients should be considered at a higher risk of severe disease due to the limited data available.Case presentationWe describe a moderate course of COVID-19 in a patient who underwent a liver transplant two years earlier due to Budd-Chiari syndrome. She presented with malaise, headache, dry cough and fever for four days. Immunosuppressive therapy with tacrolimus and mycophenolate mofetil was continued throughout the course of infection, oxygen therapy was given for a single night and the patient gradually recovered with supportive care only.ConclusionsWith this case report, we demonstrate that liver transplantation and immunosuppression is not necessarily associated with severe COVID-19 disease and emphasize that more information on this matter is urgently required. Withdrawal of immunosuppressive therapy could be associated with a higher mortality.

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Successful treatment of severe COVID-19 pneumonia in a liver transplant recipient

Cited by 79 publications

References 10 publications

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

COVID-19 pneumonia in lung transplant recipients: Report of 2 cases

Recovery of moderate COVID-19 disease in a liver transplant recipient on continued immunosuppression

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