Novel coronavirus (SARS-CoV-2) infection in a renal transplant recipient: Case report

Ning, Ling; Liu, Lei; Li, Wenyuan; Liu, Hongtao; Wang, Jizhou; Yao, Ziqin; Zhang, Shengyu; Zhao, Donghui; Nashan, Björn; Shen, Adong; Liu, Lianxin; Li, Lei

doi:10.1111/ajt.15897

Cited by 70 publications

(70 citation statements)

References 17 publications

(7 reference statements)

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“…It is also thought that corticosteroids may inhibit immune response, reduce pathogen clearance, and increase viral shedding if administered early during the clinical course of SARS‐CoV‐2 or with mild disease 22‐24 . Finally, currently published cases of SARS‐CoV‐2 in renal transplant recipients have demonstrated variable results in progression of respiratory disease and survival when substituting higher doses of corticosteroids for complete cessation of maintenance calcineurin inhibitor and antiproliferative therapy 4,7‐17 .…”

Section: Discussionmentioning

confidence: 99%

“…Recipients described were between 1 month and 22 years post‐transplant with most patients presenting with severe respiratory symptoms requiring oxygen. Immunosuppressant management in 30 patients consisted of complete cessation of calcineurin inhibitor and antiproliferative therapy with reliance on corticosteroid monotherapy, typically with intravenous methylprednisolone 4,7‐17 . Only three patients were managed without making any change in their baseline immunosuppressive regimen, and one of these patients was receiving a steroid‐sparing regimen at baseline.…”

Section: Review Of Published Literature In Renal Transplant Recipientsmentioning

confidence: 99%

“…Additionally, broad‐spectrum antibiotic therapy was administered to 34 patients. The average duration of symptoms from those who reported was 21 days, with 18% of patients progressing to respiratory failure requiring mechanical ventilation 4,7‐17 . Eight patients who had presented with severe or critical oxygen needs had died by the time of case publication; all eight patients had immunosuppressant therapy converted to corticosteroid monotherapy while hospitalized 8,11,15,16 …”

Section: Review Of Published Literature In Renal Transplant Recipientsmentioning

confidence: 99%

“…At this time, supportive care is paramount to combating this virus in solid organ transplant recipients. Very little data are currently available regarding the optimal medical management of renal transplant patients testing positive for SARS‐CoV‐2 including strategies for reducing or modifying immunosuppression 4,7‐17 . Corticosteroids are a cornerstone of many immunosuppressive regimens; however, their use in SARS‐CoV‐2 is controversial 18‐22 .…”

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confidence: 99%

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Managing COVID‐19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid‐sparing Immunosuppression

et al. 2020

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Novel coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome virus (SARS‐CoV‐2) has become a global health care crisis. The Centers for Disease Control and Prevention (CDC) lists immunocompromised patients, including those requiring immunosuppression following renal transplantation, as high risk for severe disease from SARS‐CoV‐2. Treatment for other viral infections in renal transplant recipients often includes a reduction in immunosuppression; however, no current guidelines are available recommending the optimal approach to managing immunosuppression in the patients who are infected with SARS‐CoV‐2. It is currently advised to avoid corticosteroids in the treatment of SARS‐CoV‐2 outside of critically ill patients. Recently published cases describing inpatient care of COVID‐19 in renal transplant recipients differ widely in disease severity, time from transplantation, baseline immunosuppressive therapy, and the modifications made to immunosuppression during COVID‐19 treatment. This review summarizes and compares inpatient immunosuppressant management strategies of recently published reports in the renal transplant population infected with SARS‐CoV‐2 and discusses the limitations of corticosteroids in managing immunosuppression in this patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Review Of Published Literature In Renal Transplant Recipientsmentioning

confidence: 99%

Section: Review Of Published Literature In Renal Transplant Recipientsmentioning

confidence: 99%

mentioning

confidence: 99%

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Managing COVID‐19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid‐sparing Immunosuppression

et al. 2020

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“…Health Commission). 10 Overall, the progression of disease has varied but appears to be more rapid in immunocompromised hosts with greater rates of ICU admission and death (a fatality rate of ~21.4%). Potential antiviral effects of immunosuppressants are untested.…”

Section: Nosocomial Transmission Is Common R O (Transmission Kineticmentioning

confidence: 99%

Novel Coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve

Fishman

Grossi

2020

American Journal of Transplantation

107

103

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The comparison of clinical, laboratory, and radiological findings in immunocompromised and immunocompetent patients with COVID‐19: A case‐control study

Abasian

Jafari

SeyedAlinaghi

et al. 2023

Immunity Inflam & Disease

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Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes coronavirus disease 2019 (COVID‐19) with significant morbidity and mortality. We reported and compared the clinical and para‐clinical findings of immunocompromised and immunocompetent COVID‐19 patients in a case‐control study at the Imam Khomeini hospital in Tehran, Iran. Methods In this study, 107 immunocompromised COVID‐19 patients were recruited as the case group, and 107 immunocompetent COVID‐19 patients as the control group. The participants were matched based on age and sex. The patients' information was retrieved from the hospital records in an information sheet. Associations between clinical and para‐clinical findings with the immune status were assessed using bivariate and multivariate analyses. Results The initial pulse rate and recovery time were significantly higher in immunocompromised patients ( p < .05). Myalgia, nausea/vomiting, loss of appetite, headache, and dizziness were more frequently reported by the control group ( p < .05). Regarding the prescribed medications' duration, Sofosbovir was used longer in the case group, while Ribavirin was used longer in the control groups ( p < .05). The most common complication in the case group was acute respiratory distress syndrome, although no major complications were observed in the control group. According to the multivariate analysis, recovery time and Lopinavir/Ritonavir (Kaletra) prescription were significantly higher in the immunocompromised compared to the immunocompetent group. Conclusion Recovery time was significantly longer in the immunocompromised compared to the immunocompetent group, which emphasizes the necessity of prolonged care in these high‐risk patients. Also, it is recommended to investigate the effect of novel therapeutic interventions to reduce the recovery time in addition to improving the prognosis of immunodeficient patients with COVID‐19.

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Novel coronavirus (SARS-CoV-2) infection in a renal transplant recipient: Case report

Cited by 70 publications

References 17 publications

Managing COVID‐19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid‐sparing Immunosuppression

Managing COVID‐19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid‐sparing Immunosuppression

Novel Coronavirus-19 (COVID-19) in the immunocompromised transplant recipient: #Flatteningthecurve

The comparison of clinical, laboratory, and radiological findings in immunocompromised and immunocompetent patients with COVID‐19: A case‐control study

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