A single-center report of COVID-19 disease course and management in liver transplanted pediatric patients.
Pediatr Transplant
; 25(7): e14061, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1255459
ABSTRACT
BACKGROUND:
In 2019, SARS-CoV-2 causing COVID-19 emerged. Severe COVID-19 symptoms may evolve by virtue of hyperactivation of the immune system. Equally, immunocompromised patients may be at increased risk to develop COVID-19. However, treatment guidelines for children following liver transplantation are elusive.METHODS:
As a liver transplantation center, we diagnosed and followed up 10 children (male/female 8/2) with a median age of 8.5 years (IQR 5.2-11.0), with COVID-19 post-liver transplant between March 2019 and December 2020. COVID-19 diagnosis was based on PCR test and or florid X-ray findings compatible with COVID-19 in the absence of other cause. We retrospectively collected clinical and laboratory data from electronic patient records following written consent from patients/parents.RESULTS:
Nine patients were diagnosed as definitive (PCR positive) with one patient being diagnosed as probable COVID-19. Seven patients recovered without any support whereas three were admitted for non-invasive oxygenation. Lymphopenia and/or high levels of serum IL-6 were detected in four patients. Six patients mounted anti-SARS-CoV-2 antibodies at median 30 days (IQR 26.5-119.0) following COVID-19 diagnosis. Antibiotic therapy, favipiravir, anakinra, and IVIG were used as treatment in 4,1,1 and 2 patients, respectively. Furthermore, we kept the tacrolimus with or without everolimus but stopped MMF in 2 patients. Importantly, liver allograft function was retained in all patients.CONCLUSIONS:
We found that being immunocompromised did not affect disease severity nor survival. Stopping MMF yet continuing with tacrolimus was an apt treatment modality in these patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
RNA, Viral
/
Liver Transplantation
/
Disease Management
/
Transplant Recipients
/
SARS-CoV-2
/
COVID-19
/
Liver Diseases
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
English
Journal:
Pediatr Transplant
Journal subject:
Pediatrics
/
Transplantation
Year:
2021
Document Type:
Article
Affiliation country:
Petr.14061
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