Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Hasan Abad Sq, 11367-46911, Tehran, Iran.
Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
CEN Case Rep. 2021 Nov;10(4):494-499. doi: 10.1007/s13730-021-00584-z. Epub 2021 Mar 26.
The novel coronavirus disease 2019 (COVID-19) is a respiratory infection that has received much attention due to its rapid expansion. Currently, it has been revealed that patients with underlying disease, especially those with kidney disease are more prone to develop complications. Some studies associate kidney transplantation as a risk factor for COVID-19 progression; however, epidemiologic data that demonstrate this are amazingly rare. Considering the importance of the topic, we report on six kidney transplant recipients (median age 47 [41-55]) with confirmed or clinically suspected COVID-19. The most common admission presentations were fever (83.3%), dyspnea, and myalgia. At baseline, immunosuppressive therapy was ceased, prednisolone dose was increased, and all patients received antiviral treatment including hydroxychloroquine and umifenovir. After a median follow-up of 11.5 days from admission, six patients (100%) developed acute kidney injury (AKI), 50% required intensive care unit (ICU) admission, and two patients (33.3%) deceased as a result of deterioration in respiratory status. Overall, these findings demonstrate that respiratory involvement may be a risk indicator of in-hospital mortality in kidney recipients with COVID-19. In addition, AKI development in kidney recipients with COVID-19 is of utmost importance given the higher AKI occurrence in these patients compared with others. Therefore, more intensive attention should be paid to kidney transplant recipients with COVID-19.
2019 年新型冠状病毒病（COVID-19）是一种呼吸道传染病，由于其迅速蔓延而备受关注。目前已经发现，患有基础疾病的患者，尤其是患有肾病的患者更容易发生并发症。一些研究将肾移植与 COVID-19 进展的风险因素联系起来；然而，表明这一点的流行病学数据却非常罕见。考虑到这一主题的重要性，我们报告了 6 例确诊或临床疑似 COVID-19 的肾移植受者（中位年龄 47 [41-55] 岁）。最常见的入院表现为发热（83.3%）、呼吸困难和肌痛。在基线时，停止了免疫抑制治疗，增加了泼尼松龙剂量，所有患者均接受了抗病毒治疗，包括羟氯喹和乌米福韦。在入院后中位随访 11.5 天，6 例患者（100%）发生急性肾损伤（AKI），50%需要入住重症监护病房（ICU），2 例患者（33.3%）因呼吸状况恶化而死亡。总的来说，这些发现表明，呼吸受累可能是 COVID-19 肾移植受者住院死亡率的一个风险指标。此外，与其他患者相比，COVID-19 肾移植受者 AKI 的发生更为常见，因此 COVID-19 肾移植受者 AKI 的发生更为重要。因此，应该更加关注 COVID-19 肾移植受者。
