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

查看全文 作　　者：Anna [1,2]Sessa;Alessandra [2,3]Mazzola;Chetana [4]Lim;Mohammed [5]Atif;Juliana [2,6]Pappatella;Valerie [7]Pourcher;Olivier [3,4]Scatton;Filomena [2,3,8]Conti 高影响力作者 机构地区：[1]Department of Hepatology and Gastroenterology,University of Naples Federico II,Napoli 80131,Italy;[2]APHP,Unite Medicale de Transplantation Hepatique Hopital Pitie Salpetriere,Paris 75013,France;[3]Sorbonne Universite,INSERM,Centre de Recherche Saint-Antoine(CRSA),Paris 75013,France;[4]APHP,Unite de Chirurgie Hepatobiliaire et Transplantation Hepatique,Hopital Pitie Salpetriere,Paris 75013,France;[5]APHP,Centre d’immunologie et des Maladies Infectieuses,Inserm U1135,Hopital Pitie-Salpetriere,Paris 75013,France;[6]Hospital Felicio Rocho,Barro Preto 9530,Brazil;[7]APHP,Service des Maladies Infectieuses,Hopital Pitie Salpetriere,Paris 75013,France;[8]Sorbonne Universite,INSERM,Institute of Cardiometabolisme and Nutrition(ICAN),Paris 75013,France高影响力机构 出　　处：《World Journal of Gastroenterology》索引2020年第26卷第44期,共9页高影响力期刊 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×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. 关 键 词：Liver transplantation COVID-19 IMMUNOSUPPRESSION Gastrointestinal symptom Infection Case report
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