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Two distinct cases with COVID-19 in kidney transplant recipients

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Author(s)
Yaerim KimOhyun KwonJin H. PaekWoo Y. ParkKyubok JinMiri HyunJi Y. LeeHyun A. KimSeungyeup Han
Keimyung Author(s)
Kim, Yae RimPaek, Jin HyukPark, Woo YoungJin, Kyu BokHyun, Mi RiLee, Ji YeonKim, Hyun AhHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Issued Date
2020
Volume
20
Issue
8
Keyword
clinical research/practiceimmunosuppressantinfection and infectious agents – viralinfectious diseasekidney (allograft) function/dysfunctionkidney transplantation/nephrology
Abstract
The fatality of novel coronavirus disease 2019 (COVID‐19) is precipitously increased in patients with underlying comorbidities or elderly people. Kidney transplant (KT) recipients are one of the vulnerable populations for infection. COVID‐19 infection in KT recipients might be a complicated and awkward situation, but there has been a lack of reports concerning this group. Herein, we demonstrated two distinct cases with different clinical progress. The first case was a 36‐year‐old man who underwent KT 3 years ago. He was diagnosed with COVID‐19 expressing relevant symptoms. Following administration of lopinavir/ritonavir and hydroxychloroquine with reduced immunosuppressant, he recovered from COVID‐19. However, the unexpected fluctuations in tacrolimus trough levels needed to be managed because of drug‐to‐drug interaction. The second case was developed in a 56‐year‐old man without any symptoms. He received a second KT from an ABO‐incompatible donor 8 years ago. He was diagnosed with COVID‐19 by screening due to exposure history. During the hospitalization period, the chest infiltrative lesion showed a wax and wane, but he successfully recovered by administration of hydroxychloroquine with azithromycin. These apparently different cases suggest that assertive screening and management could improve the clinical course. In addition, antiviral agents should be used cautiously, especially in patients on calcineurin inhibitors.
Keimyung Author(s)(Kor)
김예림
백진혁
박우영
진규복
현미리
이지연
김현아
한승엽
Publisher
School of Medicine (의과대학)
Citation
Yaerim Kim et al. (2020). Two distinct cases with COVID-19 in kidney transplant recipients. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 20(8), 2269–2275. doi: 10.1111/ajt.15947
Type
Article
ISSN
1600-6143
Source
https://onlinelibrary.wiley.com/doi/10.1111/ajt.15947
DOI
10.1111/ajt.15947
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42948
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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