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Case Reports
. 2020 Jul;20(7):1916-1921.
doi: 10.1111/ajt.15928. Epub 2020 May 4.

Clinical characteristics and immunosuppressant management of coronavirus disease 2019 in solid organ transplant recipients

Zibiao Zhong  1 , Qiuyan Zhang  1 , Haoyang Xia  1 , Aiping Wang  2 , Wenjin Liang  1 , Wei Zhou  1 , Lihua Zhou  1 , Xiao Liu  2 , Lingzhang Rao  2 , Zhifeng Li  3 , Zhiyong Peng  3 , Pingzheng Mo  4 , Yong Xiong  4 , Shaojun Ye  1 , Yanfeng Wang  1 , Qifa Ye  1
Affiliations
Case Reports

Clinical characteristics and immunosuppressant management of coronavirus disease 2019 in solid organ transplant recipients

Zibiao Zhong et al. Am J Transplant. 2020 Jul.

Abstract

Over 1 000 000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 9 days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living-related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.

Keywords: COVID-19; clinical characteristics; immunosuppressant; solid organ transplant recipient.

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Figures

FIGURE 1
FIGURE 1
The timeline of clinical diagnosis and treatment of the COVID-19-positive liver transplant recipient during hospitalization (A) and changes of his liver function and immune status in the meantime (B-F) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
The timeline of clinical diagnosis and treatment of the COVID-19-positive kidney transplant recipient during hospitalization (A) and changes of his renal function and immunosuppressant concentration in the meantime (B,C) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Changes in chest CT scan of these two COVID-19-positive SOT recipients during hospitalization. A-C: pulmonary imaging of liver transplant recipient; D-F: pulmonary imaging of renal transplant recipient [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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