[COVID-19 and renal transplantation]. / COVID-19 und Nierentransplantation.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic poses a particular risk for kidney transplant recipients. This is due to a high prevalence of comorbidities as well as therapeutic immunosuppression, which plays a complex role in view of the severe hyperinflammation contributing to morbidity and mortality. Many published case series including kidney transplant recipients reported a high proportion of hospitalized cases and mortality rates of 13-23%. The clinical symptoms and established risk factors for severe disease seem to be similar to those of the general population. The management of immunosuppressive treatment is a delicate question in the treatment of kidney transplant recipients with COVID-19. According to the current recommendations, a stepwise reduction should be carried out depending on the clinical course of the disease. Ongoing efforts to find an effective treatment for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) focus on repurposing known antiviral and anti-inflammatory substances. To date, only dexamethasone has shown to be an effective treatment in the subgroup of patients requiring oxygen supplementation; however, countless trials including novel therapeutic approaches are ongoing.