Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series
Background. Kidney transplant recipients (KTRs) were reported to be at higher risk of developing severe coronavirus disease-2019 (COVID-19). Despite being one of the most impacted countries, little is known about KTRs with COVID-19 in Indonesia. This report aims to explore the management strategies...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2022/9636624 |
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| author | Maruhum Bonar H. Marbun Riahdo J. Saragih Tantika Andina |
| author_facet | Maruhum Bonar H. Marbun Riahdo J. Saragih Tantika Andina |
| author_sort | Maruhum Bonar H. Marbun |
| collection | DOAJ |
| description | Background. Kidney transplant recipients (KTRs) were reported to be at higher risk of developing severe coronavirus disease-2019 (COVID-19). Despite being one of the most impacted countries, little is known about KTRs with COVID-19 in Indonesia. This report aims to explore the management strategies and short-term clinical outcomes of KTRs with COVID-19 in an Indonesian transplant center. Methods. We observed KTRs who were admitted following COVID-19 diagnosis. Anamnesis, physical, laboratory, and radiologic examinations were performed. Demographic and transplant histories were recorded, along with symptoms, vaccination status, and management related to COVID-19. Results. Nineteen KTRs were observed and 14 (73.6%) were male. The most common presenting symptoms were fever, cough, and shortness of breath. Nine (47.3%) KTRs had severe-critical COVID-19. The mortality rate was 42.1%. Acute kidney injury (AKI) was present in six (31.6%) of KTRs, five (83.3%) of whom were nonsurvivors. The median D-dimer level was higher in nonsurvivors (5,800 versus 670 μL), while other laboratory parameters were comparable. Seven (36.8%) KTRs were vaccinated. The mortality rates of vaccinated and unvaccinated KTRs were 14.2% and 70%, respectively. Antiviral therapy, anticoagulant, intravenous immunoglobulin, and tocilizumab were prescribed to 89.5%, 89.5%, 15.8%, and 10.5%, respectively. Immunosuppressive therapy (IST) was halted in 68% of KTRs, among which 61.5% passed away. Conclusion. The clinical presentation of COVID-19 in KTRs was similar to that in the general population, whereas the mortality rate was higher. Management strategies for KTRs with COVID-19 should include prevention of AKI and hypercoagulation. Vaccination seems to be beneficial for KTRs, while temporary withdrawal of IST does not. |
| format | Article |
| id | doaj-art-df400d227f2145b3ba59976e6399e7b3 |
| institution | Kabale University |
| issn | 2090-2158 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-df400d227f2145b3ba59976e6399e7b32025-02-03T06:04:39ZengWileyInternational Journal of Nephrology2090-21582022-01-01202210.1155/2022/9636624Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case SeriesMaruhum Bonar H. Marbun0Riahdo J. Saragih1Tantika Andina2Division of Nephrology and HypertensionDivision of Nephrology and HypertensionDivision of Nephrology and HypertensionBackground. Kidney transplant recipients (KTRs) were reported to be at higher risk of developing severe coronavirus disease-2019 (COVID-19). Despite being one of the most impacted countries, little is known about KTRs with COVID-19 in Indonesia. This report aims to explore the management strategies and short-term clinical outcomes of KTRs with COVID-19 in an Indonesian transplant center. Methods. We observed KTRs who were admitted following COVID-19 diagnosis. Anamnesis, physical, laboratory, and radiologic examinations were performed. Demographic and transplant histories were recorded, along with symptoms, vaccination status, and management related to COVID-19. Results. Nineteen KTRs were observed and 14 (73.6%) were male. The most common presenting symptoms were fever, cough, and shortness of breath. Nine (47.3%) KTRs had severe-critical COVID-19. The mortality rate was 42.1%. Acute kidney injury (AKI) was present in six (31.6%) of KTRs, five (83.3%) of whom were nonsurvivors. The median D-dimer level was higher in nonsurvivors (5,800 versus 670 μL), while other laboratory parameters were comparable. Seven (36.8%) KTRs were vaccinated. The mortality rates of vaccinated and unvaccinated KTRs were 14.2% and 70%, respectively. Antiviral therapy, anticoagulant, intravenous immunoglobulin, and tocilizumab were prescribed to 89.5%, 89.5%, 15.8%, and 10.5%, respectively. Immunosuppressive therapy (IST) was halted in 68% of KTRs, among which 61.5% passed away. Conclusion. The clinical presentation of COVID-19 in KTRs was similar to that in the general population, whereas the mortality rate was higher. Management strategies for KTRs with COVID-19 should include prevention of AKI and hypercoagulation. Vaccination seems to be beneficial for KTRs, while temporary withdrawal of IST does not.http://dx.doi.org/10.1155/2022/9636624 |
| spellingShingle | Maruhum Bonar H. Marbun Riahdo J. Saragih Tantika Andina Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series International Journal of Nephrology |
| title | Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series |
| title_full | Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series |
| title_fullStr | Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series |
| title_full_unstemmed | Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series |
| title_short | Management of COVID-19 in Kidney Transplant Recipients: A Single-Center Case Series |
| title_sort | management of covid 19 in kidney transplant recipients a single center case series |
| url | http://dx.doi.org/10.1155/2022/9636624 |
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