Punga Daniela, Isac Sebastian, Paraipan Cristian, Cotorogea Mihail, Stefan Andreea, Cobilinschi Cristian, Vacaroiu Ileana Adela, Tulin Raluca, Ionescu Dorin, Droc Gabriela
Department of Anesthesiology and Intensive Care I, Fundeni Clinical Institute, Bucharest, ROU.
Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital, Bucharest, ROU.
Cureus. 2022 Feb 28;14(2):e22687. doi: 10.7759/cureus.22687. eCollection 2022 Feb.
The first case of coronavirus disease 2019 (COVID-19) was diagnosed in December 2019 in Wuhan, China. Since then, this novel infectious disease, caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), has grown into a pandemic with over 330 million infected individuals worldwide, many of them with innate or acquired immunosuppression. Liver transplantation (LT) is offered as a curative therapy for end-stage liver disease as well as for acute liver failure cases. Advances in immunosuppressive therapy decreased the rates of acute and chronic graft rejection, significantly improving the quality of life. Liver transplant recipients are considered at particularly high risk for developing critical COVID-19 infection because of their chronic immunosuppressed state. Available data are heterogeneous, and the mortality rate is variably reported in the literature. There is controversy regarding whether their immunosuppressive status is a risk or a protective factor for developing severe respiratory disease. Moreover, the mechanism of action is still unclear. We report the clinical outcome of three liver transplant recipients who had COVID-19 pneumonia at different moments following liver transplantation. All patients received a standard immunosuppression regimen and specific antiviral therapy, requiring no invasive mechanical ventilation. They were discharged from the hospital with no long-term COVID-19 complications.
2019年12月，中国武汉确诊了首例2019冠状病毒病（COVID-19）。自那时起，这种由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起的新型传染病已发展成为一场全球大流行，全球感染人数超过3.3亿，其中许多人有先天性或后天性免疫抑制。肝移植（LT）被用作终末期肝病以及急性肝衰竭病例的一种治愈性疗法。免疫抑制疗法的进展降低了急性和慢性移植物排斥反应的发生率，显著改善了生活质量。肝移植受者因其慢性免疫抑制状态而被认为发生重症COVID-19感染的风险特别高。现有数据参差不齐，文献中报告的死亡率也各不相同。关于他们的免疫抑制状态是发生严重呼吸道疾病的风险因素还是保护因素存在争议。此外，作用机制仍不清楚。我们报告了三名肝移植受者在肝移植后不同时间发生COVID-19肺炎的临床结果。所有患者均接受了标准免疫抑制方案和特异性抗病毒治疗，无需有创机械通气。他们出院时没有出现长期COVID-19并发症。
