Reply to “Coronaviruses and immunosuppressed patients. The facts during the third epidemic”

Merli, Marco; Perricone, Giovanni; Lauterio, Andrea; Prosperi, Manlio; Travi, Giovanna; Roselli, Elena; Petrò, Laura; De Carlis, Luciano; Belli, Luca; Puoti, Massimo

We read with interest the letter by D’Antiga evaluating the early experience with Coronavirus‐19 disease (COVID‐19) in liver transplant (LT) recipients in Bergamo and suggesting the absence of correlation between immunosuppression and severity of disease. We report two cases of early liver transplant recipients infected by SARS‐CoV‐2 with only mild clinical manifestations. On the contrary, long‐term recipients with comorbities showed a more aggressive course and worse prognosis. Considering the emerging evidence of the contribution of immune activation in the severity of the COVID‐19, immunosuppression may in part prevent a more aggressive course of the disease.