Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.7076
Peer-review started: May 5, 2020
First decision: May 15, 2020
Revised: May 22, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: November 28, 2020
Coronavirus disease (COVID) is a new and highly contagious infectious disease caused by the coronavirus (COVID-19 or severe acute respiratory syndrome coronavirus 2). There is limited data regarding the incidence and management of COVID-19 in immunocompromised patients’ post-transplantation. In the pre-COVID-19 era, these patients were already at an increased risk of developing opportunistic infections. These often manifested with atypical symptoms.
We report another case of uneventful COVID-19 pneumonia in a 58-year old male who was 18 mo’ post liver transplantation. He received tacrolimus monotherapy since July 2019. The clinical manifestations included only epigastric pain radiating to the right hypochondrium, nausea and vomiting. He had no fevers, cough, shortness of breath, anosmia or dysgeusia even if the chest computed tomography scan revealed an extension of the multiple patchy ground-glass density shadows to the upper lobe of the left lung too. He was hospitalised and received a course of oral chloroquine (200 mg × 3 per day) for a period of 10 d. Interestingly, the COVID 19 infection was uneventful though there were no modifications to his tacrolimus dosing. He was successfully discharged. We performed subsequent follow-up via telemedicine.
In light of the current pandemic, it is even more important to identify how the liver recipient’s patients present and are managed, especially for immunosuppression treatment.
Core Tip: Coronavirus disease (COVID) is a novel and unknown infectious disease that involves all the world due to a novel coronavirus (named severe acute respiratory syndrome coronavirus 2 latter). Immunocompromised patients often present atypical presentations of viral diseases. We report a case of a COVID-19 infection in a liver transplant recipient, in which the first clinical symptoms were abdominal pain without fever or respiratory symptoms. The immunosuppression seems to be doesn’t worsen the prognostic of COVID-19 pneumonia for this patient but future studies including more patients are needed to explore the impact of COVID-19 infections in this special setting.