Department of Internal Medicine, Faculty of Medicine Airlangga University, Airlangga University Hospital, Surabaya, Indonesia.
Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia.
J Infect Dev Ctries. 2021 Sep 30;15(9):1257-1262. doi: 10.3855/jidc.14952.
Severe COVID-19 infection management for a recipient of kidney transplant has debatable prognosis and treatment. We described the case of a COVID-19 infected 70 year old female, previously had renal transplantation in 2017. The patient took immunosuppressive agents as routine drugs for transplant recipient status and received lopinavir/ritonavir, hydroxychloroquine, and dexamethasone daily at the hospitalization. Specific question arises about renal transplant recipients being infected by COVID-19 - whether the infection will get worse compared to those without immunosuppresive agent. In this case, author decided to stop the immunosuppressive agent followed administration of combination lopinavir/ritonavir, hydroxychloroquine, and dexamethasone that gives a good clinical impact change to patient's condition after once getting worsened and mechanically ventilated. Nevertheless, the assessment of risk and benefit in continuing immunosuppressive drugs is concurrently essential due to the prevention of transplant rejection.
对于接受肾移植的患者来说，严重 COVID-19 感染的管理具有争议性的预后和治疗方法。我们描述了一例 COVID-19 感染的 70 岁女性患者，该患者曾于 2017 年接受过肾移植。患者作为移植受者常规服用免疫抑制剂，住院期间每天接受洛匹那韦/利托那韦、羟氯喹和地塞米松治疗。对于感染 COVID-19 的肾移植受者，存在一个具体问题，即与未使用免疫抑制剂的患者相比，感染是否会更严重。在这种情况下，作者决定停用免疫抑制剂，并给予洛匹那韦/利托那韦、羟氯喹和地塞米松联合治疗，在患者病情恶化并接受机械通气后，该治疗方案对患者病情产生了良好的临床影响变化。然而，由于需要预防移植排斥，同时需要评估继续使用免疫抑制剂的风险和获益。
