Prognosis and Treatment of Liver Transplant Recipients in the COVID-19 Era: A Literature Review
| Autor: | Samir Abu-Gazala, Ashraf Imam, Oded Cohen-Arazi, Abed Khalaileh, Alon J. Pikarsky, H. Merhav, Rifaat Safadi, Sadi A. Abukhalaf |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Pneumonia Viral Population 030230 surgery Liver transplantation Organ transplantation Betacoronavirus 03 medical and health sciences 0302 clinical medicine Prednisone Internal medicine medicine Humans Infection control education Pandemics Review Paper Infection Control Transplantation education.field_of_study SARS-CoV-2 business.industry Liver Diseases Mortality rate COVID-19 Immunosuppression Organ Transplantation General Medicine SARS Virus Prognosis medicine.disease Liver Transplantation Pneumonia 030211 gastroenterology & hepatology Coronavirus Infections business medicine.drug |
| Zdroj: | Annals of Transplantation |
| ISSN: | 2329-0358 |
| DOI: | 10.12659/aot.926196 |
| Popis: | Liver transplantation during the COVID-19 pandemic is challenging. Both donor and recipient issues can be influenced by the risks attributed to the pandemic. Allocation policy may need to be modified and criteria may be influenced by local infection rates and availability of medical facilities. Modifying immunosuppression (IS) protocols is controversial and is not evidence-based. In this study, we review the published literature on liver transplant recipients who were infected with COVID-19. A literature review was performed using PubMed, ScienceDirect, and WHO databases to identify relevant English-language articles published up to May 20, 2020. Fifteen articles reported 120 liver transplant recipients who were infected with COVID-19. Only 10 papers with 22 patients reported full encounter characteristics. Four papers reported 23, 17, 13, and 6 patients, respectively, but with minimal data. One paper reported the authors' own 39 patients' characteristics and demographics. The mean age was 58.2 years with 66% males. The most commonly reported presentations in descending order were fever (91%), cough (36.7%), shortness of breath (SOB) (31.8%), and diarrhea (31.8%). Liver transplant patients infected with COVID-19 were maintained on Tac (79%), mycophenolate (MMF) (48.4%), and Prednisone (29.6%) and were managed by reducing MMF in 14.3% of patients and reducing Tac in 14.3% of patients; 28.6% of patients needed ICU admission, 13.6% of patients had died, and the reported general population COVID-19 mortality rate was 3.4%. The clinical presentation of COVID-19 in liver transplant recipients may be different from the general population, with higher rates of severe disease, complications, and mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|