Introduction Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to millions of deaths worldwide. Kidney transplant recipients (KTRs) are a fragile population due to their immunosuppressed status. However, there are limited studies available comparing this population with the general population regarding clinical symptoms, and laboratory and imaging features as well as disease severity and clinical outcomes. Methods A total of 24 KTRs and 40 patients from the general population (control group) were enrolled after applying exclusion criteria. Clinical symptoms, laboratory values, and lung involvement patterns in high-resolution computed tomography (HRCT) were compared between KTRs with COVID-19 and their counterparts from the general population. Moreover, the category of disease severity and adverse outcomes such as intensive care unit (ICU) admission, mechanical ventilation (MV), and mortality rate were also compared between these two groups. Results Hypertension was significantly higher among KTRs. Dyspnea was significantly more among the control group (P = 0.045). There was no significant difference in the rest of clinical symptoms (P > 0.05). There was no significant difference in CT features as well, except pleural effusion, which was more prevalent in the control group. A lower absolute lymphocytic count (ALC) and platelet count were observed in KTRs. Renal transplant recipients (RTRs) had a higher elevation in creatinine level than their counterparts. The ICU admission, MV, duration of hospital stay, and mortality as adverse outcomes were not significantly different between the KTR and control groups. Conclusion In conclusion, there was no significant difference in the severity and risk of adverse outcomes, including MV, ICU admission, and mortality between KTRs under chronic immunosuppression and the control group.

On February 19, 2020, the first confirmed case of Coronavirus disease 2019, known as COVID-19, was identified in Iran. Afterward, the disease spread rapidly throughout the country. Some of the cases were asymptomatic, some had mild to severe symptoms, and some of them died. Transplant patients are highly at risk due to long-term immunosuppressive therapy, and precise treatment approaches are needed to not only cure the disease but also protect graft function. This study reports two kidney transplant patients with COVID-19 pneumonia, both of whom showed respiratory and gastrointestinal symptoms. High cyclosporine and tacrolimus trough levels were observed despite initial dose reduction. After a treatment program containing reduced immunosuppressant dose and the addition of pulsatile hydrocortisone, these patients recovered effectively. We also discuss the importance of drug-drug interactions related to COVID-19 treatment protocol medications, especially with immunosuppressants, in these patients. In conclusion, frequent monitoring of the trough levels of calcineurin and mammalian target of rapamycin inhibitors during hospitalization is recommended since it helps to determine the ideal treatment and prevent serious clinical toxicity.

Included were consenting patients over the age of 18 who had been on chronic hemodialysis for more than 3 months and no history of hospitalization in the last month. Without modifying the clinically established dry weight, we measured weight and total body water by using Tanita's bathroom scale (SF-BIA technology) before and after hemodialysis session for 6 successive sessions. These measures were compared with results from clinical measures. Comparison of the repeated measurements was performed using a Student's t-test on paired samples and the agreement was evaluated by linear regression and Brand-Altman analysis. Results: 264 measurements were performed in 22 patients. The average age was 46.6AE13.1 years, with 54.5% of men and an average duration of dialysis of 92.3 AE 46.8 months. During the hemodialysis session, there was a significant reduction in weight (65AE17.1 kg pre-dialysis compared with 62.9AE17.0 kg post-dialysis, p <0.0001) and total body water (TBW) measured by BIA (TBW BIA ¼ 36.3AE7.1 L pre-dialysis versus 33.0AE6.8 L post-dialysis, p <0.0001) or calculated by the Watson equation (TBW Watson ¼ 35.8AE6.9 L pre-dialysis against 35.2AE6.8 L post-dialysis, p <0.0001). This finding was expected and we guessed that the impedance in our patients was higher at the end than at the beginning of the session since the electrical conduction decreases when there is less water. We found a strong linear correlation and a concordance between the two TBW measurements in predialysis. This correlation remained high in non-concordance postdialysis with a mean of-2.2 differences, a very wide agreement limit (-5.9 and +1.5), and a significant difference in measurements.