Diagnosis and treatment of novelcoronavirus pneumonia after kidney transplant: a report of 2 cases / 中华器官移植杂志

ABSTRACT

Objective:To explore the clinical features and managements of novel coronavirus (2019-nCoV) infection after kidney transplantation.Methods:The authors reviewed medical history, laboratory values, imaging studies, treatment options and clinical outcomes of two confirmed hospitalized cases of COVID-19 after kidney transplant in February 2020. Both cases were middle-aged males and confirmed as COVID-19 at 11 or 12 months after transplantation. They both presented initially with moderate-to-low fever, cough and fatigue. Chest computed tomography (CT) hinted at multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary. Both had varying degrees of renal function and cardiac insufficiency.Results:In case 1, the dose of immunosuppressants was tapered while a higher dose of glucocorticoids was prescribed during treatment. In case 2, the dose of immunosuppressants was not tapered and continuous renal replacement therapy (CRRT) performed thrice in the early disease course due to renal insufficiency and hyperkalemia. Both cases received oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy, antibiotics treatment. Both cases were cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 patients after kidney transplantation are not significantly different from those of other people. However, early renal function and heart function abnormalities occur. How to adjust the immunosuppressant in the treatment course of severe COVID-19 after renal transplantation should be further explored.