Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Oct;22(5):e13371.
doi: 10.1111/tid.13371. Epub 2020 Jul 13.

COVID-19 in kidney transplant recipients: A multicenter experience in Istanbul

Erol Demir  1 , Murathan Uyar  2 , Ergun Parmaksiz  3 , Ayse Sinangil  4 , Berna Yelken  5 , Ahmet Burak Dirim  1 , Ozgur Merhametsiz  2 , Serap Yadigar  3 , Zuhal Atan Ucar  4 , Ali Riza Ucar  1 , Mehmet Emin Demir  2 , Meral Mese  3 , Emin Baris Akin  4   6 , Nurana Garayeva  1 , Seda Safak  1 , Ozgur Akin Oto  1 , Halil Yazici  1 , Aydin Turkmen  1   5
Affiliations
Multicenter Study

COVID-19 in kidney transplant recipients: A multicenter experience in Istanbul

Erol Demir et al. Transpl Infect Dis. 2020 Oct.

Abstract

Introduction: Management of COVID-19 in kidney transplant recipients should include treatment of the infection, regulation of immunosuppression, and supportive therapy. However, there is no consensus on this issue yet. This study aimed to our experiences with kidney transplant recipients diagnosed with COVID-19.

Material and methods: Kidney transplant recipients diagnosed with COVID-19 from five major transplant centers in Istanbul, Turkey, were included in this retrospective cohort study. Patients were classified as having moderate or severe pneumonia for the analysis. The primary endpoint was all-cause mortality. The secondary endpoints were acute kidney injury, the average length of hospital stay, admission to intensive care, and mechanical ventilation.

Results: Forty patients were reviewed retrospectively over a follow-up period of 32 days after being diagnosed with COVID-19. Cough, fever, and dyspnea were the most frequent symptoms in all patients. The frequency of previous induction and rejection therapy was significantly higher in the group with severe pneumonia compared to the moderate pneumonia group. None of the patients using cyclosporine A developed severe pneumonia. Five patients died during follow-up in the intensive care unit. None of the patients developed graft loss during follow-up.

Discussion: COVID-19 has been seen to more commonly cause moderate or severe pneumonia in kidney transplant recipients. Immunosuppression should be carefully reduced in these patients. Induction therapy with lymphocyte-depleting agents should be carefully avoided in kidney transplant recipients during the pandemic period.

Keywords: COVID-19; acute kidney injury; adult; antiviral agents; cytokine release syndrome; cytokine-targeted therapy; kidney transplantation; respiratory distress syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the patients in the study. COVID‐19, coronavirus disease 2019
FIGURE 2
FIGURE 2
Treatment scheme for COVID‐19 in kidney transplant recipients. AZM, azithromycin; CNI, calcineurin inhibitors; COVID‐19, coronavirus disease 2019; CSS, cytokine storm syndrome; HCQ, hydroxychloroquine; ICU, intensive care unit; KTR, kidney transplant recipient; RT‐PCR, reverse transcription‐polymerase chain reaction
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Banerjee D, Popoola J, Shah S, Ster IC, Quan V, Phanish M. COVID‐19 infection in kidney transplant recipients. Kidney International. 2020;97 (6):1076–1082. 10.1016/j.kint.2020.03.018 - DOI - PMC - PubMed
    1. Akalin E, Azzi Y, Bartash R, et al. Covid‐19 and Kidney Transplantation. New England Journal of Medicine. 2020;382 (25):2475–2477. 10.1056/nejmc2011117 - DOI - PMC - PubMed
    1. The Columbia University Kidney Transplant Program . Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York. Journal of the American Society of Nephrology. 2020;31 (6):1150–1156. 10.1681/asn.2020030375 - DOI - PMC - PubMed
    1. Alberici F, Delbarba E, Manenti C, et al. A single center observational study of the clinical characteristics and short‐term outcome of 20 kidney transplant patients admitted for SARS‐CoV2 pneumonia. Kidney International. 2020;97 (6):1083–1088. 10.1016/j.kint.2020.04.002 - DOI - PMC - PubMed
    1. Montagud‐Marrahi E, Cofan F, Torregrosa JV, et al. Preliminary data on outcomes of SARS‐CoV‐2 infection in a Spanish single center cohort of kidney recipients. American Journal of Transplantation. 2020; 10.1111/ajt.15970 - DOI - PMC - PubMed

Publication types

MeSH terms

Substances