Management of immunosuppression in kidney transplant recipients with COVID-19 pneumonia: A summary of 41 confirmed cases reported worldwide.
Transpl Infect Dis
; 23(1): e13425, 2021 Feb.
Article
in English
| MEDLINE | ID: covidwho-670599
ABSTRACT
There is no consensus on immunosuppression management for kidney transplant recipients (KTRs) with SARS-CoV-2 pneumonia. Therefore, we conducted a search in English database from October 2019 to July 2020 and extracted data from cases with treatment details worldwide, and total of 41 recipients with a median age of 50 years were enrolled in this study. Most of them were males (75.8%). The most common presenting symptoms were fever (80.5%), cough (63.4%), and fatigue (41.5%). Patients were classified into three catalogs according to severity of pneumonia 17 (41.5%) were mild, 15 (36.6%) severe, and 9 (21.9%) critical disease. Laboratory tests revealed that serum creatinine of critical patients was significantly higher than that of mild or severe patients. 68.3% received oxygen support; all patients received antiviral therapy, and 15 (36.6%) recipients were additionally treated with intravenous immunoglobulin and interferon-α. 19.5% of patients maintained immunosuppressive therapy; 36.6% suspended antimetabolite; and 43.9% only treated with corticosteroid. Six (14.6%) patients died (severe 2, critical 4); high creatinine with low lymphocyte count was the biggest challenge of immunosuppression management. In all, it is necessary to pay close attention to renal function and lymphocyte count in KTRs infected with COVID-19 and choose appropriate medication programs according to the specific situations.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Kidney Transplantation
/
Transplant Recipients
/
SARS-CoV-2
/
COVID-19
/
Immunosuppressive Agents
Type of study:
Prognostic study
Topics:
Long Covid
Limits:
Adolescent
/
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
/
Young adult
Language:
English
Journal:
Transpl Infect Dis
Journal subject:
Transplantation
Year:
2021
Document Type:
Article
Affiliation country:
Tid.13425
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