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Coronavirus disease 2019 infection in kidney transplant recipients: A clinical case series

Masoumeh Asgharpour1, Zeinab Mohseni Afshar2, Soheil Ebrahimpour3

  • 1Department of Nephrology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|January 12, 2022
PubMed

Insights

Kidney transplant recipients face higher risks for severe COVID-19. Immunosuppressive therapy may mitigate severe outcomes by preventing cytokine storms, though high D-dimer levels indicate a worse prognosis.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Immunology

Background:

  • Kidney transplant recipients (KTRs) are vulnerable to severe coronavirus disease 2019 (COVID-19) due to comorbidities and chronic immunosuppression.
  • Understanding COVID-19 outcomes in KTRs is crucial for managing this high-risk population.

Observation:

  • This study presents four cases of COVID-19 infection in kidney transplant recipients.
  • Clinical data, including D-dimer levels and immunosuppressive regimens, were analyzed for each case.

Findings:

  • One patient with high D-dimer levels on tacrolimus experienced the most severe outcome.
  • Other patients demonstrated better outcomes, potentially linked to the immunosuppressive therapy mitigating COVID-19-induced cytokine storms.
  • Elevated D-dimer levels were associated with critical illness and may serve as a prognostic indicator in KTRs with COVID-19.

Implications:

  • Immunosuppressive therapy might offer a protective effect against hyperinflammation in KTRs with COVID-19.
  • Monitoring D-dimer levels could be important for risk stratification and predicting outcomes in kidney transplant recipients diagnosed with COVID-19.
  • Further research is warranted to elucidate the complex interplay between immunosuppression, D-dimer levels, and COVID-19 severity in KTRs.

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