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COVID-19 in Liver Transplant Recipients - A Series with Successful Recovery

Ashok Choudhury, Golamari Srinivasa Reddy, Shantan Venishetty, Viniyendra Pamecha, Saggere Muralikrishna Shasthry, Arvind Tomar, Lalita Gauri Mitra, Venkata Siva Tez Prasad, Rajendra Prasad Mathur, Debajyoti Bhattacharya, Shiv Kumar Sarin
Journal of Clinical and Translational Hepatology , Volume 8, pp 1-7; doi:10.14218/jcth.2020.00061

Abstract: The severe acute respiratory syndrome corona virus-2 (referred to as SARS CoV2) pandemic had a great impact on public life in general as well as on populations with pre-existing disease and co-morbidities. Liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosuppression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/o convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anticoagulation, consideration of repurposed drugs (i.e. teicoplanin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.
Keywords: Treatment / virus / antivirals / immunosuppression / outcomes / liver transplant / Recipients / COVID

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