Two clinical cases of novel coronavirus pneumonia (COVID-19) in renal transplant recipients
10.3760/cma.j.cn421203-20200210-00033
- VernacularTitle:肾移植受者继发新型冠状病毒肺炎二例临床报告
- Author:
Yafang TU
1
;
Xiongfei WU
;
Feng LIU
;
Juan WANG
;
Yu LUO
;
Zhitao CAI
;
Rengui CHEN
;
Wenliang LIAO
;
Na LIU
;
Jing HUANG
Author Information
1. 武汉大学人民医院肾病与透析移植中心 430060
- From:
Chinese Journal of Organ Transplantation
2020;41(3):144-147
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features, diagnosis and prognosis of renal transplant recipients with COVID-19.Methods:The clinical data were retrospectively analyzed for 2 kidney transplant recipients with COVID-19. Based upon clinical manifestations, blood routine, inflammatory factors, cell immunity, chest computed tomography(CT)and therapeutic efficacies, the diagnosis and treatment of COVID-19 in kidney transplant recipients(Interim Edition V)were compared to that of ordinary COVID-19 patients. Both recipients had an onset of low/moderate fever. There was no initial symptom of cough or fatigue. Blood routine indicated a normal count of leukocytes, a marked lymphocytopenia, elevated C-reactive protein(CRP)and slightly higher procalcitonin(PCT). Cellular immunity was extremely low and chest CT showed multiple patchy ground-glass opacities in both lungs.Results:After 1 week of onset, both patients had a marked disease progression. The pathogenesis and imaging changes were highly similar to those reported for ordinary COVID-19 patients. For preventing secondary infections, both received symptomatic supportive measures of antiviral agents, withdrawing immunosuppressants, tapering of hormone maintenance dose, intravenous drip of gamma globulin and respiratory supports. Currently the conditions of both patients obviously improved and renal function was stable. One case recovered and was discharged.Conclusions:The clinical manifestations of COVID-19 in renal transplant recipients are generally consistent with that of ordinary COVID-19 patients. Although there is no established treatment for COVID-19, withdrawing immunosuppressants, maintaining small and medium doses of hormones, actively restoring immunity and providing respiratory supports in a timely manner are effective.
