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Artikel ; Online: Influenza co-infection associated with severity and mortality in COVID-19 patients.

Alosaimi, Bandar / Naeem, Asif / Hamed, Maaweya E / Alkadi, Haitham S / Alanazi, Thamer / Al Rehily, Sanaa Saad / Almutairi, Abdullah Z / Zafar, Adnan

Virology journal

2021 Band 18, Heft 1, Seite(n) 127

Abstract: ... of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and ... infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death ... a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was ...

Abstract	Background: In COVID-19 patients, undetected co-infections may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. Therefore, we investigated the implications of viral and bacterial co-infection in COVID-19 clinical outcomes. Methods: Nasopharyngeal samples were obtained from 48 COVID-19 patients (29% ICU and 71% non-ICU) and screened for the presence of 24 respiratory pathogens using six multiplex PCR panels. Results: We found evidence of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and human adenovirus (n = 10) were the most commonly detected pathogens. Viral co-infection was associated with increased ICU admission (r = 0.1) and higher mortality (OR 1.78, CI = 0.38-8.28) compared to bacterial co-infections (OR 0.44, CI = 0.08-2.45). Two thirds of COVID-19 critically ill patients who died, had a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen (r = 0.2). Conclusions: Our study highlights the importance of screening for co-infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high prevalence of Influenza co-infection in our study, increased coverage of flu vaccination is encouraged to mitigate the transmission of influenza virus during the on-going COVID-19 pandemic and reduce the risk of severe outcome and mortality.
Mesh-Begriff(e)	Adult ; Aged ; Bacterial Infections/epidemiology ; Bacterial Infections/mortality ; Bacterial Infections/pathology ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/pathology ; Coinfection/epidemiology ; Coinfection/mortality ; Coinfection/pathology ; Female ; Hospitalization ; Humans ; Influenza A Virus, H1N1 Subtype/isolation & purification ; Influenza, Human/epidemiology ; Influenza, Human/mortality ; Influenza, Human/pathology ; Intensive Care Units ; Male ; Middle Aged ; Nasopharynx/microbiology ; Nasopharynx/virology ; Prevalence ; SARS-CoV-2/isolation & purification ; Saudi Arabia/epidemiology
Sprache	Englisch
Erscheinungsdatum	2021-06-14
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2160640-7
ISSN	1743-422X ; 1743-422X
ISSN (online)	1743-422X
ISSN	1743-422X
DOI	10.1186/s12985-021-01594-0
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Influenza co-infection associated with severity and mortality in COVID-19 patients

Alosaimi, Bandar / Naeem, Asif / Hamed, Maaweya E / Alkadi, Haitham S / Alanazi, Thamer / Al Rehily, Sanaa Saad / Almutairi, Abdullah Z / Zafar, Adnan

Virology journal. 2021 Dec., v. 18, no. 1

2021

Abstract: ... of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and ... in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high ... a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was ...

Abstract	BACKGROUND: In COVID-19 patients, undetected co-infections may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. Therefore, we investigated the implications of viral and bacterial co-infection in COVID-19 clinical outcomes. METHODS: Nasopharyngeal samples were obtained from 48 COVID-19 patients (29% ICU and 71% non-ICU) and screened for the presence of 24 respiratory pathogens using six multiplex PCR panels. RESULTS: We found evidence of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and human adenovirus (n = 10) were the most commonly detected pathogens. Viral co-infection was associated with increased ICU admission (r = 0.1) and higher mortality (OR 1.78, CI = 0.38–8.28) compared to bacterial co-infections (OR 0.44, CI = 0.08–2.45). Two thirds of COVID-19 critically ill patients who died, had a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen (r = 0.2). CONCLUSIONS: Our study highlights the importance of screening for co-infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high prevalence of Influenza co-infection in our study, increased coverage of flu vaccination is encouraged to mitigate the transmission of influenza virus during the on-going COVID-19 pandemic and reduce the risk of severe outcome and mortality.
Schlagwörter	COVID-19 infection ; Chlamydophila pneumoniae ; Influenza A virus ; Mastadenovirus ; death ; disease severity ; influenza ; mixed infection ; mortality ; pathogens ; polymerase chain reaction ; risk reduction ; vaccination ; virology
Sprache	Englisch
Erscheinungsverlauf	2021-12
Umfang	p. 127.
Erscheinungsort	BioMed Central
Dokumenttyp	Artikel
ISSN	1743-422X
DOI	10.1186/s12985-021-01594-0
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Cardiovascular implications of COVID-19 versus influenza infection: a review.

Khan, Muhammad Shahzeb / Shahid, Izza / Anker, Stefan D / Solomon, Scott D / Vardeny, Orly / Michos, Erin D / Fonarow, Gregg C / Butler, Javed

BMC medicine

2020 Band 18, Heft 1, Seite(n) 403

Abstract: ... and differences between influenza and COVID-19 and the potential risks associated with coincident ... pandemics.: Main body: COVID-19 has a higher mortality compared to influenza with case fatality rate ... regarding co-infection of COVID-19 with influenza or how it would progress clinically, though it may cause ...

Abstract	Background: Due to the overlapping clinical features of coronavirus disease 2019 (COVID-19) and influenza, parallels are often drawn between the two diseases. Patients with pre-existing cardiovascular diseases (CVD) are at a higher risk for severe manifestations of both illnesses. Considering the high transmission rate of COVID-19 and with the seasonal influenza approaching in late 2020, the dual epidemics of COVID-19 and influenza pose serious cardiovascular implications. This review highlights the similarities and differences between influenza and COVID-19 and the potential risks associated with coincident pandemics. Main body: COVID-19 has a higher mortality compared to influenza with case fatality rate almost 15 times more than that of influenza. Additionally, a significantly increased risk of adverse outcomes has been noted in patients with CVD, with ~ 15 to 70% of COVID-19 related deaths having an underlying CVD. The critical care need have ranged from 5 to 79% of patients hospitalized due to COVID-19, a proportion substantially higher than with influenza. Similarly, the frequency of vascular thrombosis including deep venous thrombosis and pulmonary embolism is markedly higher in COVID-19 patients compared with influenza in which vascular complications are rarely seen. Unexpectedly, while peak influenza season is associated with increased cardiovascular hospitalizations, a decrease of ~ 50% in cardiovascular hospitalizations has been observed since the first diagnosed case of COVID-19, owing in part to deferred care. Conclusion: In the coming months, increasing efforts towards evaluating new interventions will be vital to curb COVID-19, especially as peak influenza season approaches. Currently, not enough data exist regarding co-infection of COVID-19 with influenza or how it would progress clinically, though it may cause a significant burden on an already struggling health care system. Until an effective COVID-19 vaccination is available, high coverage of influenza vaccination should be of utmost priority.
Mesh-Begriff(e)	Adult ; COVID-19/complications ; COVID-19/epidemiology ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/epidemiology ; Coinfection/epidemiology ; Female ; Humans ; Influenza, Human/complications ; Influenza, Human/epidemiology ; Male ; Middle Aged ; SARS-CoV-2
Sprache	Englisch
Erscheinungsdatum	2020-12-18
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-020-01816-2
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Bacterial co-infections in community-acquired pneumonia caused by SARS-CoV-2, influenza virus and respiratory syncytial virus.

Hedberg, Pontus / Johansson, Niclas / Ternhag, Anders / Abdel-Halim, Lina / Hedlund, Jonas / Nauclér, Pontus

BMC infectious diseases

2022 Band 22, Heft 1, Seite(n) 108

Abstract: ... mortality was compared in patients with and without bacterial co-infection, adjusting for age, sex and co ... groups. Comparing SARS-CoV-2 positive patients with and without bacterial co-infection at admission ... logistic regression models and creation of two scoring systems based on disease severity, age, co-morbidities and ...

Abstract	Background: A mismatch between a widespread use of broad-spectrum antibiotic agents and a low prevalence of reported bacterial co-infections in patients with SARS-CoV-2 infections has been observed. Herein, we sought to characterize and compare bacterial co-infections at admission in hospitalized patients with SARS-CoV-2, influenza or respiratory syncytial virus (RSV) positive community-acquired pneumonia (CAP). Methods: A retrospective cohort study of bacterial co-infections at admission in SARS-CoV-2, influenza or RSV-positive adult patients with CAP admitted to Karolinska University Hospital in Stockholm, Sweden, from year 2011 to 2020. The prevalence of bacterial co-infections was investigated and compared between the three virus groups. In each virus group, length of stay, ICU-admission and 30-day mortality was compared in patients with and without bacterial co-infection, adjusting for age, sex and co-morbidities. In the SARS-CoV-2 group, risk factors for bacterial co-infection, were assessed using logistic regression models and creation of two scoring systems based on disease severity, age, co-morbidities and inflammatory markers with assessment of concordance statistics. Results: Compared to influenza and RSV, the bacterial co-infection testing frequency in SARS-CoV-2 was lower for all included test modalities. Four percent [46/1243 (95% CI 3-5)] of all SARS-CoV-2 patients had a bacterial co-infection at admission, whereas the proportion was 27% [209/775 (95% CI 24-30)] and 29% [69/242 (95% CI 23-35)] in influenza and RSV, respectively. S. pneumoniae and S. aureus constituted the most common bacterial findings for all three virus groups. Comparing SARS-CoV-2 positive patients with and without bacterial co-infection at admission, a relevant association could not be demonstrated nor excluded with regards to risk of ICU-admission (aHR 1.53, 95% CI 0.87-2.69) or 30-day mortality (aHR 1.28, 95% CI 0.66-2.46) in adjusted analyses. Bacterial co-infection was associated with increased inflammatory markers, but the diagnostic accuracy was not substantially different in a scoring system based on disease severity, age, co-morbidities and inflammatory parameters [C statistic 0.66 (95% CI 0.59-0.74)], compared to using disease severity, age and co-morbidities only [C statistic 0.63 (95% CI 0.56-0.70)]. Conclusions: The prevalence of bacterial co-infections was significantly lower in patients with community-acquired SARS-CoV-2 positive pneumonia as compared to influenza and RSV positive pneumonia.
Mesh-Begriff(e)	Adult ; COVID-19 ; Coinfection/epidemiology ; Humans ; Orthomyxoviridae ; Pneumonia, Viral ; Respiratory Syncytial Virus, Human ; Retrospective Studies ; SARS-CoV-2 ; Staphylococcus aureus
Sprache	Englisch
Erscheinungsdatum	2022-01-31
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07089-9
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Corticosteroids for CAP, influenza and COVID-19: when, how and benefits or harm?

Martin-Loeches, Ignacio / Torres, Antoni

European respiratory review : an official journal of the European Respiratory Society

2021 Band 30, Heft 159

Abstract: ... of corticosteroids in patients with influenza has shown to be associated with significantly higher mortality and ... in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear ... higher incidence of nosocomial infection, while in patients with coronavirus disease 2019 (COVID-19 ...

Abstract	Purpose: Corticosteroids have been considered in medicine for a long time, and they are broadly prescribed. In infectious diseases, corticosteroids have been regarded as a thread due to their immunosuppressive effects and therefore their anti-inflammatory properties. MAIN: In recent years, there have been several studies published that aimed to determine the role of corticosteroids in patients with community-acquired pneumonia (CAP), because, despite significant advances in new antibiotics and supportive care, deaths of patients with CAP remain unacceptably high. While the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) CAP guidelines did not mention the use of corticosteroids in the management of CAP, the recently published 2019 IDSA/ATS guidelines recommended their use in patients with septic shock refractory to vasopressors and fluid resuscitation. Regarding viral infection, the use of corticosteroids in patients with influenza has shown to be associated with significantly higher mortality and higher incidence of nosocomial infection, while in patients with coronavirus disease 2019 (COVID-19) there is a good body of evidence of the benefit of corticosteroids in terms of mortality. Conclusions: The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease.
Mesh-Begriff(e)	Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; COVID-19/drug therapy ; Clinical Decision-Making ; Community-Acquired Infections/drug therapy ; Humans ; Influenza, Human/drug therapy ; Patient Safety ; Risk Assessment ; Risk Factors ; Treatment Outcome
Chemische Substanzen	Adrenal Cortex Hormones
Sprache	Englisch
Erscheinungsdatum	2021-02-09
Erscheinungsland	England
Dokumenttyp	Journal Article ; Review
ZDB-ID	1077620-5
ISSN	1600-0617 ; 0905-9180
ISSN (online)	1600-0617
ISSN	0905-9180
DOI	10.1183/16000617.0346-2020
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: COVID-19 is not "just another flu": a real-life comparison of severe COVID-19 and influenza in hospitalized patients in Vienna, Austria.

Pawelka, Erich / Karolyi, Mario / Mader, Theresa / Omid, Sara / Kelani, Hasan / Baumgartner, Sebastian / Ely, Sarah / Hoepler, Wolfgang / Jilma, Bernd / Koenig, Franz / Laferl, Hermann / Traugott, Marianna / Turner, Michael / Seitz, Tamara / Wenisch, Christoph / Zoufaly, Alexander

Infection

2021 Band 49, Heft 5, Seite(n) 907–916

Abstract: ... patients, COVID-19 is associated with longer LOS, a higher number of complications and higher ... Background: COVID-19 is regularly compared to influenza. Mortality and case-fatality rates vary ... comparing hospitalized patients with COVID-19 and influenza is scarce.: Methods: Data from patients ...

Abstract	Background: COVID-19 is regularly compared to influenza. Mortality and case-fatality rates vary widely depending on incidence of COVID-19 and the testing policy in affected countries. To date, data comparing hospitalized patients with COVID-19 and influenza is scarce. Methods: Data from patients with COVID-19 were compared to patients infected with influenza A (InfA) and B (InfB) virus during the 2017/18 and 2018/19 seasons. All patients were ≥ 18 years old, had PCR-confirmed infection and needed hospital treatment. Demographic data, medical history, length-of-stay (LOS), complications including in-hospital mortality were analyzed. Results: In total, 142 patients with COVID-19 were compared to 266 patients with InfA and 300 with InfB. Differences in median age (COVID-19 70.5 years vs InfA 70 years and InfB 77 years, p < 0.001) and laboratory results were observed. COVID-19 patients had fewer comorbidities, but complications (respiratory insufficiency, pneumonia, acute kidney injury, acute heart failure and death) occurred more frequently. Median length-of-stay (LOS) was longer in COVID-19 patients (12 days vs InfA 7 days vs. InfB 7 days, p < 0.001). There was a fourfold higher in-hospital mortality in COVID-19 patients (23.2%) when compared with InfA (5.6%) or InfB (4.7%; p < 0.001). Conclusion: In hospitalized patients, COVID-19 is associated with longer LOS, a higher number of complications and higher in-hospital mortality compared to influenza, even in a population with fewer co-morbidities. This data, a high reproduction number and limited treatment options, alongside excess mortality during the SARS-CoV-2 pandemic, support the containment strategies implemented by most authorities.
Mesh-Begriff(e)	Adolescent ; Austria ; COVID-19 ; Hospitalization ; Humans ; Influenza, Human/epidemiology ; Pandemics ; SARS-CoV-2
Sprache	Englisch
Erscheinungsdatum	2021-05-13
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	185104-4
ISSN	1439-0973 ; 0300-8126 ; 0173-2129
ISSN (online)	1439-0973
ISSN	0300-8126 ; 0173-2129
DOI	10.1007/s15010-021-01610-z
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Clinical characteristics and outcome of influenza virus infection among adults hospitalized with severe COVID-19: a retrospective cohort study from Wuhan, China.

Tong, Xunliang / Xu, Xiaomao / Lv, Guoyue / Wang, He / Cheng, Anqi / Wang, Dingyi / Fan, Guohui / Zhang, Yue / Li, Yanming

BMC infectious diseases

2021 Band 21, Heft 1, Seite(n) 341

Abstract: ... clinical features and outcomes of severe COVID-19 patients with co-infection of influenza virus.: Methods ... spreads worldwide and co-infection of COVID-19 and influenza may occur in some cases. We aimed to describe ... Retrospective cohort study was performed and a total of 140 patients with severe COVID-19 were enrolled ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that rapidly spreads worldwide and co-infection of COVID-19 and influenza may occur in some cases. We aimed to describe clinical features and outcomes of severe COVID-19 patients with co-infection of influenza virus. Methods: Retrospective cohort study was performed and a total of 140 patients with severe COVID-19 were enrolled in designated wards of Sino-French New City Branch of Tongji Hospital between Feb 8th and March 15th in Wuhan city, Hubei province, China. The demographic, clinical features, laboratory indices, treatment and outcomes of these patients were collected. Results: Of 140 severe COVID-19 hospitalized patients, including 73 patients (52.14%) with median age 62 years were influenza virus IgM-positive and 67 patients (47.86%) with median age 66 years were influenza virus IgM-negative. 76 (54.4%) of severe COVID-19 patients were males. Chronic comorbidities consisting mainly of hypertension (45.3%), diabetes (15.8%), chronic respiratory disease (7.2%), cardiovascular disease (5.8%), malignancy (4.3%) and chronic kidney disease (2.2%). Clinical features, including fever (≥38 °C), chill, cough, chest pain, dyspnea, diarrhea and fatigue or myalgia were collected. Fatigue or myalgia was less found in COVID-19 patients with IgM-positive (33.3% vs 50/7%, P = 0.0375). Higher proportion of prolonged activated partial thromboplastin time (APTT) > 42 s was observed in COVID-19 patients with influenza virus IgM-negative (43.8% vs 23.6%, P = 0.0127). Severe COVID-19 Patients with influenza virus IgM positive have a higher cumulative survivor rate than that of patients with influenza virus IgM negative (Log-rank P = 0.0308). Considering age is a potential confounding variable, difference in age was adjusted between different influenza virus IgM status groups, the HR was 0.29 (95% CI, 0.081-1.100). Similarly, difference in gender was adjusted as above, the HR was 0.262 (95% CI, 0.072-0.952) in the COX regression model. Conclusions: Influenza virus IgM positive may be associated with decreasing in-hospital death.
Mesh-Begriff(e)	Adult ; Aged ; Antibodies, Viral/blood ; COVID-19/complications ; China ; Coinfection/virology ; Comorbidity ; Female ; Hospital Mortality ; Humans ; Immunoglobulin M/blood ; Influenza, Human/complications ; Male ; Middle Aged ; Retrospective Studies
Chemische Substanzen	Antibodies, Viral ; Immunoglobulin M
Sprache	Englisch
Erscheinungsdatum	2021-04-12
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-05975-2
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Post liver transplant recurrent and de novo viral infections.

Jothimani, Dinesh / Venugopal, Radhika / Vij, Mukul / Rela, Mohamed

Best practice & research. Clinical gastroenterology

2020 Band 46-47, Seite(n) 101689

Abstract: ... liver transplantation. With COVID-19 pandemic, post-transplant patients are at risk of SARS-Co-V2 infection. Majority ... of the LT recipients require hospitalization, and the mortality in this population is around 20 ... recurrent viral infection continues to cause major allograft dysfunction, leading to poor graft and patient ...

Abstract	Survival following liver transplantation has changed dramatically owing to improvement in surgical techniques, peri-operative care and optimal immunosuppressive therapy. Post-Liver transplant (LT) de novo or recurrent viral infection continues to cause major allograft dysfunction, leading to poor graft and patient survival in untreated patients. Availability of highly effective antiviral drugs has significantly improved post-LT survival. Patients transplanted for chronic hepatitis B infection should receive life-long nucleos(t)ide analogues, with or without HBIg for effective viral control. Patients with chronic hepatitis C should be commenced on directly acting antiviral (DAA) drugs prior to transplantation. DAA therapy for post-LT recurrent hepatitis C infection is associated with close to 100% sustained virological response (SVR), irrespective of genotype. De novo chronic Hepatitis E infection is an increasingly recognised cause of allograft dysfunction in LT recipients. Untreated chronic HEV infection of the graft may lead to liver fibrosis and allograft failure. CMV and EBV can reactivate leading to systemic illness following liver transplantation. With COVID-19 pandemic, post-transplant patients are at risk of SARS-Co-V2 infection. Majority of the LT recipients require hospitalization, and the mortality in this population is around 20%. Early recognition of allograft dysfunction and identification of viral aetiology is essential in the management of post-LT de novo or recurrent infections. Optimising immunosuppression is an important step in reducing the severity of allograft damage in the treatment of post-transplant viral infections. Viral clearance or control can be achieved by early initiation of high potency antiviral therapy.
Mesh-Begriff(e)	Humans ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Recurrence ; Risk Factors ; Survival Analysis ; Virus Diseases/etiology
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-09-26
Erscheinungsland	Netherlands
Dokumenttyp	Journal Article ; Review
ZDB-ID	2048181-0
ISSN	1532-1916 ; 1521-6918
ISSN (online)	1532-1916
ISSN	1521-6918
DOI	10.1016/j.bpg.2020.101689
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Post liver transplant recurrent and de novo viral infections

Jothimani, Dinesh / Venugopal, Radhika / Vij, Mukul / Rela, Mohamed

Best Pract Res Clin Gastroenterol

Abstract	Survival following liver transplantation has changed dramatically owing to improvement in surgical techniques, peri-operative care and optimal immunosuppressive therapy. Post-Liver transplant (LT) de novo or recurrent viral infection continues to cause major allograft dysfunction, leading to poor graft and patient survival in untreated patients. Availability of highly effective antiviral drugs has significantly improved post-LT survival. Patients transplanted for chronic hepatitis B infection should receive life-long nucleos(t)ide analogues, with or without HBIg for effective viral control. Patients with chronic hepatitis C should be commenced on directly acting antiviral (DAA) drugs prior to transplantation. DAA therapy for post-LT recurrent hepatitis C infection is associated with close to 100% sustained virological response (SVR), irrespective of genotype. De novo chronic Hepatitis E infection is an increasingly recognised cause of allograft dysfunction in LT recipients. Untreated chronic HEV infection of the graft may lead to liver fibrosis and allograft failure. CMV and EBV can reactivate leading to systemic illness following liver transplantation. With COVID-19 pandemic, post-transplant patients are at risk of SARS-Co-V2 infection. Majority of the LT recipients require hospitalization, and the mortality in this population is around 20%. Early recognition of allograft dysfunction and identification of viral aetiology is essential in the management of post-LT de novo or recurrent infections. Optimising immunosuppression is an important step in reducing the severity of allograft damage in the treatment of post-transplant viral infections. Viral clearance or control can be achieved by early initiation of high potency antiviral therapy.
Schlagwörter	covid19
Verlag	WHO
Dokumenttyp	Artikel
Anmerkung	WHO #Covidence: #797744
Datenquelle	COVID19

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