Clinical course of COVID-19 in a liver transplant recipient on hemodialysis and response to tocilizumab therapy: A case report.
Muhammad Baraa HammamiBrian T GaribaldiPali ShahGigi Y LiuTania JainPo-Hung ChenAmy K KimEdina AvdicBrent PettySara StroutDerek M FineAshwini Niranjan-AzadiWilliam M GarneauAndrew M CameronJose M Monroy TrujilloAhmet GürakarRobin K AveryPublished in: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2020)
The novel coronavirus disease 2019 (COVID-19) is a highly infectious and rapidly spreading disease. There are limited published data on the epidemiology and outcomes of COVID-19 infection among organ transplant recipients. After initial flulike symptoms, progression to an inflammatory phase may occur, characterized by cytokine release rapidly leading to respiratory and multiorgan failure. We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab. We also highlight the role of lung ultrasonography in early diagnosis of the inflammatory phase of COVID-19. Future investigation of the effects of immunomodulators among transplant recipients with COVID-19 infection will be important.
Keyphrases
- coronavirus disease
- sars cov
- respiratory syndrome coronavirus
- rheumatoid arthritis
- oxidative stress
- peritoneal dialysis
- adipose tissue
- machine learning
- mesenchymal stem cells
- randomized controlled trial
- magnetic resonance
- big data
- current status
- metabolic syndrome
- weight loss
- acute respiratory distress syndrome
- artificial intelligence
- skeletal muscle
- disease activity