TABLE 2.
COVID‐19 presentation, findings and outcome in liver transplant recipients. Summary of clinical data for each individual case
| Pt | CA or HA | COVID 19 symptoms | Chest X‐ray | COVID 19 management | Other infections |
WBC ×109/L |
Lymphocyte/neutrophil ×109/L |
IS regimen |
IS trough Tac μg/L MMF mg/L |
Liver function tests Alb g/L Bil umol/L INR Ratio AST IU/L |
GFR mL/min |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | HA | Low‐grade fever, cough | Left basal consolidation |
Isolation No change in IS Discharged |
No | 0.66 | 0.26/0.33 | CNI | Tac 3.5 |
Alb 30 Bil 57 INR1.47 AST 64 |
>90 |
| 2 | CA | Cough, fever | Consolidation RLL + ML |
ABs, CPAP 3/7, MMF stopped, pred dose doubled Inpatient |
No | 3 | NA | MMF + Pred | MMF 0.6 |
Alb 25 Bil 25 INR 1 AST NA |
66 |
| 3 | CA | No respiratory symptoms | Nil |
Isolation No change IS Discharged |
No | 10.27 | 0.8/3.88 |
CNI + Pred Azathoprine |
Tac 2.8 |
Alb 24 Bil 6 INR 1.17 AST 30 |
59 |
| 4 | CA | No respiratory symptoms | Nil |
Isolation No change in IS Discharged |
CMV | 5.22 | 0.66/3.46 |
CNI + Pred (Alemtuzumab induction 3rd transplant) |
Tac 3.2 |
Alb 42 Bil 7 INR 1.07 AST 17 |
13 |
| 5 | HA | No respiratory symptoms | Ground glass changes (longstanding) |
No change in IS, started on remdesivir Inpatient |
CMV, pulmonary IA | 1.78 | 0.71/0.86 | CNI + Pred | Tac 6.6 |
Alb 27 Bil 9 INR 1.03 AST 16 |
63 |
Abbreviations: ABs, antibiotics; Alb, albumin, normal range 35‐50 g/L; AST, aspartate aminotransferase, normal range 10‐50 IU/L; Bil, bilirubin, normal range 3‐20 μmol/L; CA, community acquired; CMV, cytomegalovirus; CNI, calcineurin inhibitor; CPAP, continuous positive airway pressure; GFR, glomerular filtration rate; GGT, gamma glutamyl transferase, normal range 1‐55 IU/L; HA, hospital acquired; IA, invasive aspergillosis; INR, international normalized ratio, normal range 0.9‐1.2 ratio; IS, immunosuppression; ML, middle lobe; MMF, mycophenolate mofetil; NA, not available; pred, prednisone; RLL, right lower lobe; tac, tacrolimus; WBC, white blood cell, normal range 4‐11 × 109/L, lymphocyte normal range 1.3‐4 × 109/L, neutrophil normal range 2.2‐6.3 × 109/L.