Pregnant kidney transplant recipients with COVID-19; a report of two cases and literature review

If managing COVID-19 alone was a major challenge, one can expect an even greater challenge in certain scenarios, such as patients with kidney disease - including kidney transplant recipients (KT) – or pregnant women. When things could not get any worse, we just met the peculiar art of overcomplicating things: pregnant kidney and simultaneous kidney-pancreas (SKP) transplant recipients with COVID-19. Gleeson and colleagues (Imperial College, London) described the first similar case in April 2020. We describe two cases of pregnant KT and SKP transplant recipients with COVID-19, at different stages, and their evolution until delivery. Maternal and fetal outcomes are significantly affected by both KT and COVID-19, requiring a multidisciplinary approach with a well-trained team of obstetricians and nephrologists, as we will describe.