COVID-19 in posttransplant patients-report of 2 cases

Am J Transplant. 2020 Jul;20(7):1879-1881. doi: 10.1111/ajt.15896. Epub 2020 Apr 17.

Abstract

Coronavirus Disease 2019 (COVID-19) has become a pandemic since March 2020. We describe here 2 cases of COVID-19 infection in a posttransplant setting. First one is a 59-year-old renal transplant recipient; the second is a 51-year-old allogeneic bone marrow transplant recipient. Both patients were on immunosuppressant therapy and had stable graft function before COVID-19 infection. After the diagnosis of COVID-19, immunosuppressive agents were discontinued and methylprednisolone with prophylactic antibiotics were initiated, however, the lung injury progressed. The T cells were extremely low in both patients after infection. Both patients died despite the maximal mechanical ventilatory support. Therefore, the prognosis of COVID-19 pneumonia following transplantation is not optimistic and remains guarded. Lower T cell count may be a surrogate for poor outcome.

Keywords: COVID-19; Coronavirus; transplantation.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Infections / complications
  • Bone Marrow Transplantation*
  • COVID-19
  • China
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / therapy
  • Cross Infection / complications
  • Fatal Outcome
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation*
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / therapy
  • Male
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / therapy
  • Postoperative Complications
  • Prognosis
  • Respiration, Artificial
  • T-Lymphocytes / cytology
  • Transplant Recipients*

Substances

  • Anti-Bacterial Agents
  • Immunosuppressive Agents
  • Methylprednisolone