Severe COVID-19 after liver transplantation, surviving the pitfalls of learning on-the-go: Three case reports

• Published in: World journal of hepatology Vol. 12; no. 10; pp. 870 - 879
• Main Authors: Alconchel, Felipe, Cascales-Campos, Pedro A, Pons, Jose A, Martínez, María, Valiente-Campos, Josefa, Gajownik, Urszula, Ortiz, María L, Martínez-Alarcón, Laura, Parrilla, Pascual, Robles, Ricardo, Sánchez-Bueno, Francisco, Moreno, Santiago, Ramírez, Pablo
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 27.10.2020
• Subjects: Case Report; COVID-19; Nosocomial infection; Case report; SARS-CoV-2; Cross infection; Liver transplantation
• DOI: 10.4254/wjh.v12.i10.870
• ISSN: 1948-5182

The novel coronavirus 2019 (COVID-19) pandemic has dramatically transformed the care of the liver transplant patient. In patients who are immunosuppressed and with multiple comorbidities, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with increased severity and mortality. The main objective of this report is to communicate our experience in the therapeutic management of SARS-CoV-2 infection in 3 liver transplant patients. Secondly, we stress the management and investigation of the contagious spreading into a liver transplant ward. The patients were two women (aged 61 years and 62 years) and one man (aged 68 years), all of them having recently received a liver transplant. All three patients required intensive care unit admission and invasive mechanical ventilation. Two of them progressed severely until death. The other one, who received tocilizumab, had a good recovery. In the outbreak, the wife of one of the patients and four healthcare professionals involved in their care were also infected. We illustrate in detail the evolution of a nosocomial COVID-19 outbreak in a liver transplant ward. We believe that these findings will contribute to a better understanding of the natural history of the disease and will improve the treatment of the liver transplant patient with COVID-19.