COVID-19 pneumonia in kidney transplant recipients-Where we are?

Abstract

In late December 2019, China reported cases of respiratory illness in humans that involved a novel coronavirus SARS-CoV-2. On March 20, 2020, the first coronavirus disease 2019 (COVID-19) in Brazil was diagnosed, and by now, we present the report on the first case of COVID among transplant recipients in our country. A liver and kidney transplant patient with SARS-CoV-2 pneumonia without respiratory failure was treated in a clinical multimodal strategy consisting of symptomatic support therapy, immunosuppression reduction, use of anti-coronavirus drugs and heparin leading to a progressive improvement of patient symptoms till discharge. The authors also present a comprehensive review of published cases.

Keywords: COVID-19; heparin; hydroxychloroquine and azithromycin; infectious diseases; kidney and liver transplantation; nonpathogen-specifc immune parameters.

FIGURE 1

CT scan (A) at admission showing bilateral ground‐glass opacities and sparse bilateral consolidation foci, predominating in peripheral regions; CT scan (B) after 4 d with reduced extension of ground‐glass opacities and appearance of parenchymal consolidation and septal thickening; CT scan (C) after 8 d with reduced extension of ground‐glass opacities and septal thickening, more parenchymal consolidation and fibrous bands in both lungs and CT scan (D) at D + 21 in a resolution stage the consolidation were partially absorbed, and residual laminar atelectasis and small parenchymal bands persisted