Journal
MEDICINE
Volume 99, Issue 24, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000020481
Keywords
COVID-19; immunosuppressant; kidney transplantation; renal function; traditional Chinese medicine
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Funding
- Major Technology Innovation of Hubei Province [2017ACA096]
- National Key Research and Development Project [2020YFC0845000]
- National Project of Emergent Science and Technology [2020YFC0841600]
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Rationale: Coronavirus disease 2019 (COVID-19) is a novel infectious disease and became a global issue. Treatment of COVID-19 especially in solid organ transplant recipients is empirical and controversial, especially the adjustment of the immunosuppressants. Patient concerns: A 29-year-old kidney transplant recipient with the symptoms of COVID-19 pneumonia. Diagnoses: COVID-19 pneumonia after kidney transplantation. Interventions: He was treated with modified immunosuppressants (unchanged dose of tacrolimus and oral corticosteroids while discontinuing mycophenolate mofetil (MMF)), antibiotics, interferon alpha-2b inhalation and traditional Chinese medicine. Outcomes: He recovered from COVID-19 pneumonia after 29 days of hospitalization. And the renal function (measured as blood urea nitrogen, serum creatinine, and urine protein) returned to normal. Lessons: In certain group of COVID-19 (e.g., mild to moderate cases, young patients without comorbidities), a reduction instead of an overall withdrawal of immunosuppressant in kidney transplant recipients is feasible.
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