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Cardiovascular Complications in Kidney Transplant Recipients with COVID-19: A Case Series

Ankita Patil1, Nikhil Rao1, Kruteesh Kumar1

  • 1Department of Nephrology, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India.

Indian Journal of Nephrology
|December 26, 2022
PubMed

Insights

Kidney transplant recipients with COVID-19 face severe cardiovascular risks, including heart attacks and myocarditis, even with low cardiovascular risk. Early recognition and management are crucial for survival in these vulnerable patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Infectious Diseases

Background:

  • Kidney transplant recipients (KTRs) exhibit increased vulnerability to severe COVID-19.
  • COVID-19 infection in KTRs is linked to significant cardiovascular complications.

Observation:

  • A study observed five KTRs with COVID-19 experiencing severe cardiovascular events.
  • These events included ST-segment myocardial infarction (STEMI), myocarditis, atrial fibrillation, and cardiogenic shock.
  • Coronary angiography in STEMI patients showed no signs of atherosclerotic coronary artery disease.

Findings:

  • Four out of five patients had low cardiovascular risk based on Framingham scores.
  • Inflammatory markers peaked during the cardiovascular events in most patients.
  • Myocardial injury and arrhythmias occurred in KTRs due to severe COVID-19, independent of traditional CV risk factors.

Implications:

  • KTRs with COVID-19 require vigilant cardiovascular monitoring, irrespective of their baseline CV risk.
  • Severe COVID-19 can precipitate acute cardiac events in KTRs through non-atherosclerotic mechanisms.
  • This highlights the need for tailored management strategies for cardiovascular complications in immunosuppressed populations during viral pandemics.

Keywords:
COVID-19Cardiovascular diseasekidney transplantmyocardial injury

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