Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence

Liver transplant recipients may face an unusually high risk for coronavirus disease 2019 (COVID-19). Observations of heightened risk, rapid progression of severe complications, greater infectivity, and potential for atypical disease presentations in transplant recipients underscore the critical impo...

Full description

Saved in:
Bibliographic Details
Main Authors: Michael T Olson, Tania Triantafyllou, Saurabh Singhal
Format: Article
Language:English
Published: SAGE Publications 2021-01-01
Series:Apollo Medicine
Subjects:
Online Access:http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2021;volume=18;issue=2;spage=101;epage=110;aulast=
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846146604725174272
author Michael T Olson
Tania Triantafyllou
Saurabh Singhal
author_facet Michael T Olson
Tania Triantafyllou
Saurabh Singhal
author_sort Michael T Olson
collection DOAJ
description Liver transplant recipients may face an unusually high risk for coronavirus disease 2019 (COVID-19). Observations of heightened risk, rapid progression of severe complications, greater infectivity, and potential for atypical disease presentations in transplant recipients underscore the critical importance of establishing an early diagnosis. Existing diagnostic approaches are marred by unreasonably high false-negative rates. Given the concerns for false-negative results, we performed a narrative review in effort to compile evidence for and against an optimal diagnostic algorithm for detecting COVID-19 in liver transplant recipients. In this algorithm, patients are triaged according to risk of severe acute respiratory syndrome coronavirus 2 infection. Initial testing is performed with reverse transcriptase-polymerase chain reaction, followed by chest computed tomography after 4 days. Repeat tests are performed as per the risk category, patient status, and urgency of transplant. Liver transplant centers should validate the algorithm presented herein, which is based on existing evidence and designed to maximize patient and provider safety, while assuring accuracy in diagnosis.
format Article
id doaj-art-8d92ac75fc63407eb7f6f5b6c64d7411
institution Kabale University
issn 0976-0016
2213-3682
language English
publishDate 2021-01-01
publisher SAGE Publications
record_format Article
series Apollo Medicine
spelling doaj-art-8d92ac75fc63407eb7f6f5b6c64d74112024-12-02T02:12:15ZengSAGE PublicationsApollo Medicine0976-00162213-36822021-01-0118210111010.4103/am.am_20_21Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidenceMichael T OlsonTania TriantafyllouSaurabh SinghalLiver transplant recipients may face an unusually high risk for coronavirus disease 2019 (COVID-19). Observations of heightened risk, rapid progression of severe complications, greater infectivity, and potential for atypical disease presentations in transplant recipients underscore the critical importance of establishing an early diagnosis. Existing diagnostic approaches are marred by unreasonably high false-negative rates. Given the concerns for false-negative results, we performed a narrative review in effort to compile evidence for and against an optimal diagnostic algorithm for detecting COVID-19 in liver transplant recipients. In this algorithm, patients are triaged according to risk of severe acute respiratory syndrome coronavirus 2 infection. Initial testing is performed with reverse transcriptase-polymerase chain reaction, followed by chest computed tomography after 4 days. Repeat tests are performed as per the risk category, patient status, and urgency of transplant. Liver transplant centers should validate the algorithm presented herein, which is based on existing evidence and designed to maximize patient and provider safety, while assuring accuracy in diagnosis.http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2021;volume=18;issue=2;spage=101;epage=110;aulast=computed tomographycoronavirus disease 2019liver transplantationreverse transcriptase-polymerase chain reactionsevere acute respiratory syndrome coronavirus 2
spellingShingle Michael T Olson
Tania Triantafyllou
Saurabh Singhal
Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
Apollo Medicine
computed tomography
coronavirus disease 2019
liver transplantation
reverse transcriptase-polymerase chain reaction
severe acute respiratory syndrome coronavirus 2
title Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
title_full Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
title_fullStr Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
title_full_unstemmed Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
title_short Optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients: Critical review of available evidence
title_sort optimal diagnostic strategy for coronavirus disease 2019 detection in liver transplant recipients critical review of available evidence
topic computed tomography
coronavirus disease 2019
liver transplantation
reverse transcriptase-polymerase chain reaction
severe acute respiratory syndrome coronavirus 2
url http://www.apollomedicine.org/article.asp?issn=0976-0016;year=2021;volume=18;issue=2;spage=101;epage=110;aulast=
work_keys_str_mv AT michaeltolson optimaldiagnosticstrategyforcoronavirusdisease2019detectioninlivertransplantrecipientscriticalreviewofavailableevidence
AT taniatriantafyllou optimaldiagnosticstrategyforcoronavirusdisease2019detectioninlivertransplantrecipientscriticalreviewofavailableevidence
AT saurabhsinghal optimaldiagnosticstrategyforcoronavirusdisease2019detectioninlivertransplantrecipientscriticalreviewofavailableevidence