Clinical follow up of renal transplant recipients with COVID-19: a case series

Abstract

COVID-19 has been recognized to become a worldwide health concern at an alarming rate over time and to be more progressive and fatal in specific risk populations. This study aims to determine the clinical features of COVID-19 in kidney transplant recipients (KTRxs) and contribute to the regulation of these patients’ immunosuppressive treatments and COVID-19 treatment protocols. The trial comprised eleven KTRxs with COVID-19. Immunosuppressive treatments such as antimetabolite cessation, calcineurin inhibitor dosage adjustments based on blood levels, and low-dose corticosteroids were all controlled. All patients received antiviral medication and low-molecular-weight-heparin (LMWH) as part of initial treatment. The steroid dose was then raised, and anti-cytokine therapies were provided in the setting of clinical worsening. The mean age of the patients was 50.3±11.2 years and 8 (73%) of them were male. The average time since transplantion was 6.82±3.34 years. Due to COVID-19 progression, the steroid dosage was raised in eight patients, anakinra and tocilizumab was added in five and one of the patients respectively. In five (%45) patients, the need for critical care arose and plasmapheresis was used in three of them. At the end of the follow-up, nine of our patients had made a complete recovery, whereas two (18.2%) had perished. Consistent with the literature, the data in presented study may also support the severe and fatal course of COVID-19 in KTRxs. It may be proposed that KTRxs with COVID-19 should be admitted to the hospital and constantly monitored, and certain effective management techniques should be initiated early depending on clinical circumstances.