Hamideh Molaei1, Leila Khedmat2, Eghlim Nemati3, Zohreh Rostami3, Seyed Hassan Saadat4. 1. Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2. Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 3. Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 4. Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: There is a high risk of COVID-19 in kidney transplant recipients (KTRs) because of chronic immunosuppression and severe cytomegalovirus (CMV) pneumonitis. CASE PRESENTATION: A case series of 10 KTRs with COVID-19 in Iran was developed. Participants consisted of two female and eight male patients, aged 46-68 years old. The data related to clinical laboratory tests, outcomes, diagnosis, and drug treatments were collected. The RT-PCR confirmed the COVID-19 infection in KTRs. The assessment of serum biochemical and blood hematological factors showed that there was a strong correlation between COVID-19 intensity and high serum Cr, BUN, and ALT levels, high CRP concentration, and lower lymphocyte and platelet counts in male KTRs. Ground-glass opacity (GGO) was the main radiologic pattern visible on both chest radiographs of computed tomography scans. The COVID-19 and CMV coinfection in KTRs resulted in large-size kidneys with severe parenchymal echogenicity and hydronephrosis. The combined use of effective antibiotic and antiviral drugs was suitable to prevent COVID-19 progression in KTRs. CONCLUSIONS: The coincidence of COVID-19 and CMV in KTRs may potentially increase the mortality risk of patients. The levels of Cr, BUN, ALT, and CRP as well as lymphocytes count in these patients should be continuously controlled.
BACKGROUND: There is a high risk of COVID-19 in kidney transplant recipients (KTRs) because of chronic immunosuppression and severe cytomegalovirus (CMV) pneumonitis. CASE PRESENTATION: A case series of 10 KTRs with COVID-19 in Iran was developed. Participants consisted of two female and eight male patients, aged 46-68 years old. The data related to clinical laboratory tests, outcomes, diagnosis, and drug treatments were collected. The RT-PCR confirmed the COVID-19infection in KTRs. The assessment of serum biochemical and blood hematological factors showed that there was a strong correlation between COVID-19 intensity and high serum Cr, BUN, and ALT levels, high CRP concentration, and lower lymphocyte and platelet counts in male KTRs. Ground-glass opacity (GGO) was the main radiologic pattern visible on both chest radiographs of computed tomography scans. The COVID-19 and CMV coinfection in KTRs resulted in large-size kidneys with severe parenchymal echogenicity and hydronephrosis. The combined use of effective antibiotic and antiviral drugs was suitable to prevent COVID-19 progression in KTRs. CONCLUSIONS: The coincidence of COVID-19 and CMV in KTRs may potentially increase the mortality risk of patients. The levels of Cr, BUN, ALT, and CRP as well as lymphocytes count in these patients should be continuously controlled.
Authors: Lúcio R Requião-Moura; Tainá Veras de Sandes-Freitas; Laila Almeida Viana; Marina Pontello Cristelli; Luis Gustavo Modelli de Andrade; Valter Duro Garcia; Claudia Maria Costa de Oliveira; Ronaldo de Matos Esmeraldo; Mario Abbud Filho; Alvaro Pacheco-Silva; Katia Cronemberger Sousa; Alessandra Rosa Vicari; Kellen Micheline Alves Henrique Costa; Denise Rodrigues Simão; Marcos Vinicius de Sousa; Juliana Bastos Campos; Ricardo Augusto Monteiro de Barros Almeida; Luciane Mônica Deboni; Miguel Moysés Neto; Juliana Aparecida Zanocco; Helio Tedesco-Silva; José Medina-Pestana Journal: PLoS One Date: 2021-07-28 Impact factor: 3.240