Italiano Jack, Bush Rachel, Acharya Ratna, Upadhyay Kiran
Pediatric Nephrology, University of Florida Health, Gainesville, Florida, USA.
Pediatrics, University of Florida, Gainesville, Florida, USA.
BMJ Case Rep. 2020 Nov 9;13(11):e239612. doi: 10.1136/bcr-2020-239612.
Renal transplant (RT) recipients are at increased risk for infectious complications. The clinical course of COVID-19 has been described in several RT recipients with varying clinical outcomes. Most present with pulmonary manifestations, however extrapulmonary presentations are not uncommon. Also, the timing and efficacy of seroconversion in transplant recipients is not well known. This report describes the duration of viral shedding and timing of seroconversion in a young adult RT recipient with COVID-19 who presented with severe diarrhoea and acute kidney injury requiring dialysis. She developed anti-SARS-CoV-2 IgG antibody after 5 weeks despite persistently shedding the virus in the nasopharynx until 6 weeks after symptom onset. Further studies are needed to determine if immunosuppressed patients have prolonged viral shedding and are still contagious despite seroconversion.
肾移植（RT）受者发生感染并发症的风险增加。已有多篇文献描述了COVID-19在数名肾移植受者中的临床病程及不同的临床结局。大多数患者表现为肺部症状，但肺外表现也并不少见。此外，移植受者血清转化的时间和效果尚不清楚。本报告描述了一名患有COVID-19的年轻成年肾移植受者的病毒脱落持续时间和血清转化时间，该患者表现为严重腹泻和急性肾损伤，需要透析治疗。尽管在症状出现后6周内鼻咽部持续有病毒脱落，但她在5周后产生了抗SARS-CoV-2 IgG抗体。需要进一步研究以确定免疫抑制患者是否存在病毒脱落延长的情况，以及血清转化后是否仍具有传染性。
