Abstract

MERINO, José Carlos de la Flor; LINARES GRAVALOS, Tania; VALGA AMADO, Francisco  and  RODELES DEL POZO, Miguel. Management of a maintenance renal transplant patient with COVID-19, in a non-transplant hospital. Rev. colom. nefrol. [online]. 2020, vol.7, n.2, pp.123-128.  Epub Apr 25, 2021. ISSN 2500-5006.  https://doi.org/10.22265/acnef.7.2.460.

SARS-CoV-2 disease (COVID-19) has dramatically increased since March 2020. There is insufficient data to establish the risk of acquiring the infection in kidney transplant recipients in comparison with the general population. The objective of this case is to report here the clinical features and therapeutic course of the renal transplant recipient with confirmed COVID-19 pneumonia in a non-transplant hospital. This is a 47-year-old woman with end stage renal disease (ESRD) of unknown cause who received kidney transplantation 14 years ago. Her clinical characteristics (symptoms, laboratory test results, and chest x-ray images) were similar to those of non-transplanted COVID-19 patients. She was treated with hydroxychloroquine, lopinavir/ritonavir, prophylactic antibiotic therapy, and a single dose of tocilizumab for COVID-19. The triple maintenance immunosuppressive therapy she was receiving was temporarily suspended due to the inability to monitor immunosuppressive drugs levels in our hospital, and low dose methylprednisolone plus five doses of flebogamma were administered instead. The COVID-19 pneumonia in this long-term immunosuppressed patient was successfully recovered without the need to assisted mechanical respiration. The renal function improved to its baseline values, maintaining moderate proteinuria. At discharge, the previous dose of his usual immunosuppressive medication was restarted.

We conclude that the experience described with our case may be useful for non-transplant hospitals, which do not have the capacity to perform immunosuppressive medication titration.

Keywords : SARS-CoV-2; COVID-19; kidney transplantation; immunosuppression (MeSH).

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )