Successful recovery of COVID-19 pneumonia in a renal transplant recipient with long-term immunosuppression

Abstract

The current outbreak of Coronavirus Disease 2019 (COVID-19) has raised great concern worldwide, but its impact on transplant recipients is unknown. We report here the clinical features and therapeutic course of the first reported renal transplant recipient with confirmed COVID-19 pneumonia. This is a 52-year-old man who received kidney transplantation 12 years ago. His overall clinical characteristics (symptoms, laboratory examinations, and chest CT) were similar to those of non-transplanted COVID-19 patients. Following a treatment regimen consisting of reduced immunosuppressant use and low dose methylprednisolone-based therapy, the COVID-19 pneumonia in this long-term immunosuppressive patient was successfully recovered. This effectively treated case has reference value for the future treatment of other transplant patients with COVID-19 pneumonia.

Keywords: COVID-19; coronavirus; immunosuppression; pneumonia; renal transplantation.

© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.

Figures

FIGURE 1

Symptoms and treatments including immunosuppressive adjustment according to day of illness and day of hospitalization

FIGURE 2

High-resolution computed tomography images before and after treatment. A, Multiple ground glass density lesions were observed in the upper and lower lobe of the lung, some with consolidation, although without obvious subpleural distribution. B, The lesion range enlarged, and new lesions were observed. C, The lesion was almost completely absorbed, leaving only a few blurs [Color figure can be viewed at wileyonlinelibrary.com]