Bilateral polysegmentary pneumonia caused by SARS-CoV-2 in a transplanted liver recipient

Background. In December 2019, the humanity met a previously unknown infectious disease (COVID-19) caused by a new coronavirus called SARS-CoV-2. An important role in the treatment of COVID-19 belongs to anti-inflammatory and immunosuppressive drugs. In this regard, the cases of the disease in patients undergoing long-term immunosuppressive therapy, for example, organ transplant recipients, are of particular interest. We present our clinical observation of COVID-19 in a liver recipient patient, which, apparently, is the first in the Russian Federation.

Clinical case description A 54-year-old man, 10 years ago at the A.I. Burnazyan Center underwent transplantation of the right lobe of the liver after resection of hepatocellular carcinoma, T2N0M0, and due to liver cirrhosis as a result of НСV hepatitis. At the time of hospitalization, he had been constantly receiving immunosuppressive monotherapy with everolimus. The patient was transferred to an infectious disease hospital due to a positive PCR test for SARS-CoV-2 RNA. No signs of respiratory failure were found upon admission. Subsequently, a mild course of COVID-19 was observed, without signs of an acute inflammatory reaction, with normal CRP values and a slight increase of ferritin. 7 days after the treatment, the patient was discharged for outpatient observation.

Conclusion. This clinical case is of interest not only by the success of the treatment of the new coronavirus infection COVID-19 in an immunocompromised patient — a recipient of a liver transplant, but also by the fact that the disease manifested itself primarily as a transient increase in hepatic aminotransferases, which can be attributed to the gastrointestinal manifestations of COVID-19.