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COVID‐19 pneumonia in kidney transplant recipients: Focus on immunosuppression management
Author(s) -
Chen Tracy Yixin,
Farghaly Sara,
Cham Samantha,
Tatem Luis Lantigua,
Sin Jonathan H.,
Rauda Roberto,
Ribisi Maria,
Sumrani Nabil
Publication year - 2020
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13378
Subject(s) - medicine , immunosuppression , pneumonia , covid-19 , intensive care medicine , kidney transplantation , kidney transplant , kidney , immunology , virology , infectious disease (medical specialty) , outbreak , disease
Background The coronavirus disease of 2019, also known as COVID‐19, has been declared a global pandemic. Significant controversies exist regarding treatment modalities for this novel disease, especially in immunocompromised patients. Experience with management of COVID‐19 in kidney transplant recipients is scarce; effects of this virus on immunosuppressed individuals are not well understood. Methods We identified 30 renal transplant recipients with confirmed COVID‐19 pneumonia who were admitted to inpatient between March 2020 and April 2020. All patients received a 5‐day course of hydroxychloroquine and azithromycin; half of the patients received methylprednisolone. During hospitalization, calcineurin inhibitors and antimetabolites were held; prednisone was continued. Results Clinical presentation of flu‐like symptoms was similar to those in the general population. Hyponatremia, lymphopenia, acute kidney injury, and elevated inflammatory markers were common. Over the course of follow‐up, 23 have been discharged home with a functioning allograft and in stable condition; 4 experienced acute kidney injury requiring renal replacement therapy; 7 patients were intubated, and 6 expired. The mortality rate in our cohort was 20%. Conclusion Our findings described the characteristics and outcomes of this highly fatal illness in a multi‐ethnic kidney transplant cohort, with insights on immunosuppression management that could further our understanding of this unique disease in immunocompromised populations.