Subject(s)
COVID-19/prevention & control , Stevens-Johnson Syndrome/etiology , Administration, Oral , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Drug-Related Side Effects and Adverse Reactions/pathology , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Skin/pathology , Stevens-Johnson Syndrome/diagnosis , Treatment OutcomeSubject(s)
Abdominal Pain/etiology , Adrenal Gland Diseases/pathology , Castleman Disease/diagnosis , Edema/pathology , Fever/etiology , Abdominal Pain/diagnosis , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Hormonal/therapeutic use , Azetidines/administration & dosage , Azetidines/therapeutic use , Bone Marrow/metabolism , Bone Marrow/pathology , Bortezomib/administration & dosage , Bortezomib/therapeutic use , Castleman Disease/drug therapy , Castleman Disease/pathology , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Drug Therapy, Combination , Fever/diagnosis , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Janus Kinase Inhibitors/administration & dosage , Janus Kinase Inhibitors/therapeutic use , Male , Middle Aged , Purines/administration & dosage , Purines/therapeutic use , Pyrazoles/administration & dosage , Pyrazoles/therapeutic use , Renal Insufficiency/etiology , Reticulin , Sulfonamides/administration & dosage , Sulfonamides/therapeutic use , Thrombocytopenia/etiologyABSTRACT
First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.
Subject(s)
Abortion, Spontaneous , Colitis, Ulcerative , Coronavirus Infections , Cyclosporine/administration & dosage , Methylprednisolone/administration & dosage , Pandemics , Pneumonia, Viral , Pregnancy Complications , Remission Induction/methods , Adult , Antiviral Agents/administration & dosage , Betacoronavirus/isolation & purification , C-Reactive Protein/analysis , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Colitis, Ulcerative/blood , Colitis, Ulcerative/complications , Colitis, Ulcerative/physiopathology , Colitis, Ulcerative/therapy , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Female , Humans , Immunosuppressive Agents/administration & dosage , Patient Acuity , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Pregnancy , Pregnancy Complications/physiopathology , Pregnancy Complications/therapy , SARS-CoV-2 , Sigmoidoscopy/methods , Treatment OutcomeSubject(s)
Abatacept/administration & dosage , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Immunosuppression Therapy/adverse effects , Kidney Failure, Chronic/complications , Kidney Transplantation , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , COVID-19 , Coronavirus Infections/diagnostic imaging , Cyclosporine/administration & dosage , Humans , Immunosuppressive Agents/administration & dosage , Kidney Failure, Chronic/surgery , Lung/diagnostic imaging , Male , Middle Aged , Mycophenolic Acid/administration & dosage , Pandemics , Pneumonia, Viral/diagnostic imaging , Prednisone/administration & dosage , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in Wuhan, China, with cases now confirmed in multiple countries. The clinical course of patients remains to be fully characterized, clinical presentation ranges from asymptomatic infection to acute respiratory distress syndrome and acute renal failure, and no pharmacological therapies of proven efficacy yet exist. We report a case of SARS-CoV-2 infection in a renal transplant recipient with excellent outcome. This case states the importance of close monitoring of the concentration of cyclosporine in patients treated with lopinavir/ritonavir; the routine treatment of corticosteroid can be continued. This is a rare report of SARS-CoV-2 infection in a renal transplant recipient. Further data are needed to achieve better understanding of the impact of immunosuppressive therapy on the clinical presentation, severity, and outcome of SARS-CoV-2 infections in solid organ transplant recipients.