Coronavirus Disease 2019 in Kidney Transplant Recipients: Our Single Center Experiences

S. Karadağ, Ramazan Uğur, E. Şam, M. Ekşi, Y. Çolakoğlu, K. Yasar
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Abstract

Objective: To investigate whether tacrolimus (Tac), mycophenolate mofetil (MMF), mycophenolic acid (MPA), prednisolone (Pred) and methylprednisolone (MP) are affect the COVID-19 pathogenesis and on its progression in kidney transplantation recipients diagnosed with COVID-19 patients. Materials and Methods: Among patients hospitalized due to COVID-19, patients who had kidney transplantation were retrospectively detected on the online database of our center. Referral complaints, laboratory and radiological data at referral, applied treatment protocols, and ultimate conditions of the patients were documented. Results: Among the total of 11 patients, 73% (8) were male and 27% (3) were female. The mean age was 49.63 (27-71). Hypertension and diabetes mellitus were the most common comorbid diseases. The most common symptoms were coughing, fever and exhaustion-fatigue. High serum reactive protein and lymphopenia were detected in almost all patients. Acute renal failure was observed in seven patients (73%). While all patients were using Tac and Pred, nine patients (82%) were using MMF and two patients (18%) were using MPA. Hydroxychloroquine, favipiravir, and azithromycin were treatments for COVID-19. RT-PCR results of 11 patients were positive in 7 and negative in 4 patients. The mean hospital stay of the discharged patients was 8.8 days. Eight patients recovered and were discharged, treatment of two intubated patients continues in intensive care unit and one patient died. Conclusion: Clinical characteristics of COVID-19 in kidney transplanted patients are similar to the general population and it should be kept in mind that the disease occurs with moderate-severe pneumonia in this patient group. Disease progress can be stopped through early treatment.
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2019冠状病毒病肾移植受者:我们的单中心经验
目的:探讨他克莫司(Tac)、霉酚酸酯(MMF)、霉酚酸(MPA)、强的松龙(Pred)和甲基强的松龙(MP)对确诊为COVID-19的肾移植受者COVID-19发病机制及进展的影响。材料与方法:在因COVID-19住院的患者中,回顾性地在我中心在线数据库中发现肾移植患者。记录了转诊投诉、转诊时的实验室和放射学数据、应用的治疗方案和患者的最终情况。结果:11例患者中男性占73%(8例),女性占27%(3例)。平均年龄49.63岁(27 ~ 71岁)。高血压和糖尿病是最常见的合并症。最常见的症状是咳嗽、发烧和疲劳。几乎所有患者血清反应蛋白升高,淋巴细胞减少。急性肾功能衰竭7例(73%)。所有患者均使用Tac和Pred, 9例患者(82%)使用MMF, 2例患者(18%)使用MPA。羟氯喹、法匹拉韦和阿奇霉素是治疗COVID-19的药物。11例患者RT-PCR结果7例阳性,4例阴性。出院患者平均住院时间8.8 d。8名患者康复出院,2名插管患者在重症监护室继续治疗,1名患者死亡。结论:肾移植患者的COVID-19临床特征与一般人群相似,但应注意该患者组伴发中重度肺炎。通过早期治疗可以阻止疾病的发展。
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