Protracted COVID‐19 pneumonitis early post‐ABO incompatible kidney transplantation: Management considerations and the role of whole genome sequencing

Abstract

We present the case of a recent ABO incompatible kidney transplant recipient with persistent SARS‐CoV‐2 infection and pneumonitis. Serial whole genome sequencing confirmed intra‐host viral evolution, which was used as a surrogate to confirm active viral replication and support re‐treatment with antivirals, late in the course of infection. A prolonged course of remdesivir combined with immunosuppression modulation resulted in successful clearance of virus and clinical improvement. The diagnostic process undertaken in this case provides a useful guide for other clinicians when approaching similar patients.