Identification of Kidney Transplant Recipients with Coronavirus Disease 2019

• Published in: European urology Vol. 77; no. 6; pp. 742 - 747
• Main Authors: Zhang, Hui, Chen, Yan, Yuan, Quan, Xia, Qiu-Xiang, Zeng, Xian-Peng, Peng, Jing-Tao, Liu, Jing, Xiao, Xing-Yuan, Jiang, Guo-Song, Xiao, Han-Yu, Xie, Liang-Bo, Chen, Jing, Liu, Jia-Li, Xiao, Xiong, Su, Hua, Zhang, Chun, Zhang, Xiao-Ping, Yang, Hua, Li, Heng, Wang, Zhen-Di
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.06.2020; European Association of Urology. Published by Elsevier B.V
• Subjects: Adult; Betacoronavirus - genetics; Betacoronavirus - immunology; Betacoronavirus - isolation & purification; China; Clinical feature; Clinical Laboratory Techniques; Coronavirus disease 2019; Coronavirus Infections - diagnosis; Coronavirus Infections - therapy; Coronavirus Infections - virology; COVID-19; COVID-19 Testing; Female; Humans; Immunocompromised Host; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Kidney transplant recipient; Kidney Transplantation - adverse effects; Male; Middle Aged; Opportunistic Infections - diagnosis; Opportunistic Infections - therapy; Opportunistic Infections - virology; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - therapy; Pneumonia, Viral - virology; Predictive Value of Tests; SARS-CoV-2; Severity of Illness Index; Time Factors; Transplant Recipients; Treatment Outcome; China; Coronavirus disease 2019; Clinical feature; Kidney transplant recipient
• ISSN: 0302-2838; 1873-7560; 1873-7560
• DOI: 10.1016/j.eururo.2020.03.030

Coronavirus disease 2019 (COVID-19) is a novel and lethal infectious disease, posing a threat to global health security. The number of cases has increased rapidly, but no data concerning kidney transplant (KTx) recipients infected with COVID-19 are available. To present the epidemiological, clinical, and therapeutic characteristics of KTx recipients infected with COVID-19, we report on a case series of five patients who were confirmed as having COVID-19 through nucleic acid testing (NAT) from January 1, 2020 to February 28, 2020. The most common symptoms on admission to hospital were fever (five patients, 100%), cough (five patients, 100%), myalgia or fatigue (three patients, 60%), and sputum production (three patients, 60%); serum creatinine or urea nitrogen levels were slightly higher than those before symptom onset. Four patients received a reduced dose of maintenance immunosuppressive therapy during hospitalization. As of March 4, 2020 NAT was negative for COVID-19 in three patients twice in succession, and their computed tomography scans showed improved images. Although greater patient numbers and long-term follow-up data are needed, our series demonstrates that mild COVID-19 infection in KTx recipients can be managed using symptomatic support therapy combined with adjusted maintenance immunosuppressive therapy.