Related Experiment Video
Updated: Nov 19, 2025
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
[COVID-19 and renal transplantation]
Florina Regele1, Rainer Oberbauer1
1Univ. Klinik für Innere Medizin III, Klinische Abteilung für Nephrologie und Dialyse, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Österreich.
Insights
Kidney transplant recipients face high COVID-19 risks due to comorbidities and immunosuppression. Management involves careful adjustment of immunosuppressive drugs and exploring treatments like dexamethasone.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Context:
- The COVID-19 pandemic presents significant risks for kidney transplant recipients.
- These patients often have comorbidities and are on immunosuppressive therapy, complicating their response to infection.
- Published data indicates high hospitalization and mortality rates (13-23%) in this vulnerable group.
Purpose:
- To review the risks and management strategies for kidney transplant recipients with COVID-19.
- To discuss the complex role of immunosuppression in COVID-19 outcomes for these patients.
- To highlight current treatment approaches and ongoing research for SARS-CoV-2 in kidney transplant recipients.
Summary:
- COVID-19 poses a severe threat to kidney transplant recipients due to comorbidities and immunosuppression.
- Clinical presentation and risk factors for severe disease appear similar to the general population.
- Management requires careful adjustment of immunosuppressive therapy based on disease severity.
- Dexamethasone is currently the only proven effective treatment for those needing oxygen, with ongoing trials for other therapies.
Impact:
- Informs clinical decision-making for managing COVID-19 in kidney transplant patients.
- Highlights the need for tailored immunosuppression strategies.
- Emphasizes the importance of ongoing research into effective treatments for this high-risk population.
- Contributes to understanding the specific challenges faced by immunocompromised individuals during viral pandemics.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic poses a particular risk for kidney transplant recipients. This is due to a high prevalence of comorbidities as well as therapeutic immunosuppression, which plays a complex role in view of the severe hyperinflammation contributing to morbidity and mortality. Many published case series including kidney transplant recipients reported a high proportion of hospitalized cases and mortality rates of 13-23%. The clinical symptoms and established risk factors for severe disease seem to be similar to those of the general population. The management of immunosuppressive treatment is a delicate question in the treatment of kidney transplant recipients with COVID-19. According to the current recommendations, a stepwise reduction should be carried out depending on the clinical course of the disease. Ongoing efforts to find an effective treatment for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) focus on repurposing known antiviral and anti-inflammatory substances. To date, only dexamethasone has shown to be an effective treatment in the subgroup of patients requiring oxygen supplementation; however, countless trials including novel therapeutic approaches are ongoing.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:30Continuous Renal Replacement Therapy