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Management of immunosuppression in kidney transplant recipients with COVID-19 pneumonia: A summary of 41 confirmed cases reported worldwide.
Hu, Qianchao; Zhong, Zibiao; Xiong, Yan; Ye, Shaojun; Wang, Yanfeng; Ye, Qifa.
  • Hu Q; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
  • Zhong Z; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
  • Xiong Y; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
  • Ye S; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
  • Wang Y; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
  • Ye Q; Institute of Hepatobiliary Diseases, Transplant Center, Hubei Key Laboratory of Medical Technology on Transplantation, Zhongnan Hospital, Wuhan University, Wuhan, China.
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.
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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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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