Renal Unit, Department of Internal Medicine, Lampang Hospital, Lampang, Thailand.
Pulmonology and Critical Care Unit, Department of Internal Medicine, Lampang Hospital, Lampang, Thailand.
J Infect Dev Ctries. 2021 Sep 30;15(9):1273-1276. doi: 10.3855/jidc.13176.
An outbreak of coronavirus disease-19 (COVID-19) has occurred in different parts of the world. Although a large piece of information regarding the epidemiology, clinical features, and management of COVID-19 has been reported in the general population, there is very limited data regarding organ transplant recipients, particularly regarding the management of maintenance immunosuppressive agents during infection.
We described a case of kidney transplant recipient from Thailand who had COVID-19 pneumonia and severe acute kidney injury.
The patient's serum creatinine peaked at 7.0 mg/dL on day 15 of illness and returned to baseline value of 2.0 mg/dL on day 26 of illness. We have shown how we modified tacrolimus, mycophenolate, and steroids in the patient who had received favipiravir and lopinavir/ritonavir for COVID-19 pneumonia.
In this case, successful modification of this immunosuppressive regimen was accomplished to reduce drug interaction complications, aiming to avoid calcineurin inhibitor nephrotoxicity while maintaining appropriate levels of immunosuppression to prevent organ rejection and to promote the patient's recovery from infection.
新型冠状病毒病-19（COVID-19）在世界不同地区爆发。虽然已经有大量关于 COVID-19 的流行病学、临床特征和管理的信息在普通人群中报道，但对于器官移植受者，特别是在感染期间管理维持性免疫抑制剂方面，数据非常有限。
我们描述了一名来自泰国的肾移植受者发生 COVID-19 肺炎和急性肾损伤的病例。
患者的血清肌酐在发病第 15 天达到 7.0mg/dL 的峰值，并在发病第 26 天恢复到 2.0mg/dL 的基线值。我们展示了我们如何在接受 favipiravir 和洛匹那韦/利托那韦治疗 COVID-19 肺炎的患者中调整他克莫司、霉酚酸酯和类固醇。
在这种情况下，成功地调整了这种免疫抑制剂方案，以减少药物相互作用的并发症，同时避免钙调神经磷酸酶抑制剂的肾毒性，同时保持适当的免疫抑制水平以预防器官排斥，并促进患者从感染中恢复。
