Coronavirus disease 2019 in an orthotopic liver transplant recipient living with human immunodeficiency virus

• Published in: Transplant infectious disease 2020-10, Vol.22 (5), p.e13351-n/a
• Main Authors: Modi, Anita R., Koval, Christine E., Taege, Alan J., Modaresi Esfeh, Jamak, Eghtesad, Bijan, Narayanan Menon, K. V., Quintini, Cristiano, Miller, Charles
• Format: Article
• Language: English
• Subjects: Adult; Anti-HIV Agents - administration & dosage; Anti-HIV Agents - adverse effects; Case Report and Review of the Literature; Chemical and Drug Induced Liver Injury - etiology; Chemical and Drug Induced Liver Injury - surgery; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - immunology; COVID-19 - virology; COVID-19 Drug Treatment; Dose-Response Relationship, Drug; Drug Therapy, Combination - methods; Graft Rejection - immunology; Graft Rejection - prevention & control; HIV; HIV Infections - drug therapy; HIV Infections - immunology; Human immunodeficiency virus; Humans; hydroxychloroquine; Hydroxychloroquine - administration & dosage; Illnesses; immunocompromised; Immunocompromised Host; Immunocompromised hosts; Immunosuppression; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Inflammation; Inflammatory response; Liver; Liver transplantation; Liver Transplantation - adverse effects; Liver transplants; Male; orthotopic liver transplantation; Precipitates; Prednisone - administration & dosage; Respiratory diseases; Respiratory distress syndrome; Ribonucleic acid; RNA; SARS-CoV-2 - immunology; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Treatment Outcome; Viral diseases; Viruses
• ISSN: 1398-2273; 1399-3062; 1399-3062
• DOI: 10.1111/tid.13351

Coronavirus disease 2019 (COVID‐19), mediated by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), can manifest with flu‐like illness and severe pneumonia with acute respiratory distress syndrome (ARDS). Immunocompromised patients merit particular attention as altered host immunity may influence both disease severity and duration of viral shedding as is described with several other ribonucleic acid respiratory viruses. Yet immunocompromised status alone, in the absence of other comorbidities, may not necessarily predict severe illness presentations and poorer clinical outcomes as indicated by recent reports of COVID‐19‐infected solid organ transplant recipients and people living with human immunodeficiency virus (HIV). Such patients may even be spared the robust inflammatory response that precipitates ARDS associated with COVID‐19, complicating the management of iatrogenic immunosuppression in this setting. We present a case of an orthotopic liver transplant recipient with well‐controlled HIV who successfully recovered from a mild, flu‐like illness attributed to SARS‐CoV‐2.