Identification of Kidney Transplant Recipients with Coronavirus Disease 2019

Eur Urol. 2020 Jun;77(6):742-747. doi: 10.1016/j.eururo.2020.03.030. Epub 2020 Apr 2.

Abstract

Coronavirus disease 2019 (COVID-19) is a novel and lethal infectious disease, posing a threat to global health security. The number of cases has increased rapidly, but no data concerning kidney transplant (KTx) recipients infected with COVID-19 are available. To present the epidemiological, clinical, and therapeutic characteristics of KTx recipients infected with COVID-19, we report on a case series of five patients who were confirmed as having COVID-19 through nucleic acid testing (NAT) from January 1, 2020 to February 28, 2020. The most common symptoms on admission to hospital were fever (five patients, 100%), cough (five patients, 100%), myalgia or fatigue (three patients, 60%), and sputum production (three patients, 60%); serum creatinine or urea nitrogen levels were slightly higher than those before symptom onset. Four patients received a reduced dose of maintenance immunosuppressive therapy during hospitalization. As of March 4, 2020 NAT was negative for COVID-19 in three patients twice in succession, and their computed tomography scans showed improved images. Although greater patient numbers and long-term follow-up data are needed, our series demonstrates that mild COVID-19 infection in KTx recipients can be managed using symptomatic support therapy combined with adjusted maintenance immunosuppressive therapy.

Keywords: Clinical feature; Coronavirus disease 2019; Kidney transplant recipient.

MeSH terms

  • Adult
  • Betacoronavirus / genetics
  • Betacoronavirus / immunology
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • China
  • Clinical Laboratory Techniques*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Opportunistic Infections / diagnosis*
  • Opportunistic Infections / therapy
  • Opportunistic Infections / virology
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / virology
  • Predictive Value of Tests
  • SARS-CoV-2
  • Severity of Illness Index
  • Time Factors
  • Transplant Recipients*
  • Treatment Outcome

Substances

  • Immunosuppressive Agents