Poor Compliance Causes Acute Rejection in Kidney Transplant Recipients During COVID-19 Pandemic: 2 Cases Report

Abstract

The COVID-19 pandemic has lasted for more than one year, which caused much trouble to the health management of kidney transplant recipients. Numerous patients cancelled their review appointment or even lost connection with doctors because of the great pressure medical system undergoing, strict travel restrictions, and the worries about COVID-19 infection risk. Herein, we introduce two kidney transplant recipients, a 33-year-old man and a 32-year-old man, who did not take the immunosuppressant drugs and did not go back to the hospital to do the renal function examination as the doctor's request. When they paid their first return visit several months after the pandemic outbreak, they were both diagnosed with acute rejection and admitted to the hospital. After receiving pulse steroid therapy, they were in remission but failed to reverse the rejection. The level of serum creatinine did not recover to the one before pandemic outbreak. These cases suggest that it is necessary to ensure that kidney transplant recipients follow the doctor's advice to take drugs and follow-up regularly to examine their renal function over pandemic period. Additionally, typical pulse steroid therapy may not that effective toward these patients.

Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis

“…After the exclusion of duplicates and articles that did not fulfill the study inclusion criteria, fifty-two articles were included in the qualitative synthesis of this systematic review. The reports of ninety-six cases (fiftysix organ rejection cases following COVID-19 vaccination [7][8][9][10][11] and forty organ rejection cases after COVID-19 infection [12][13][14][15][16][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]) identified from these articles are presented in groups based on confirmed diagnoses, laboratory, biopsy and imaging findings. The detailed characteristics of the included studies are shown in Tables 1 and 2.…”

“…Cells in the anterior chamber There were 42 case reports [5][6][7][8][11][12][13]17,18,[20][21][22][24][25][26][27][29][30][31][32][33][34][35][37][38][39][40][41][42][43][44][45][48][49][50][51][52][53][54][55][56][57], 8 case series [9,10,14,28,36,46,47,58] and 2 cohort studies [19,23]. These studies were conducted in t...…”

“…These studies were conducted in the United States (n = 14), India (n = 7), Italy (n = 5), Canada (n = 4), United Kingdom (n = 3), France (n = 3), Brazil (n = 2), Lebanon (n = 2), Australia (n = 1), Greece (n = 1), Egypt (n = 1), Denmark (n = 1), Japan (n = 1), Israel (n = 1), South Korea (n = 1), Slovakia (n = 1), Croatia (n = 1), China (n = 1), Mexico (n = 1) and Sweden (n = 1). The majority of the studies were single centre [5][6][7][8][9][11][12][13]17,18,[20][21][22][48][49][50][51][52][53][54][55][56][57][58], and only six studies were multi-centre [10,14,19,23,46,47]. The median NOS score for these studies was 6 (range, 5-7).…”

“…There were reports of forty organ rejection cases following COVID-19 infection [12][13][14][15][16][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] (see Table 2). Allograft rejections after COVID-19 infection occurred in kidney (n = 30, 75%) [12,13,16,[46][47][48][49]53,55,57,60], cornea (n = 6, 15%) [14,15,50,56,59], lung (n = 2, 5%) [52,58], liver (n = 1, 2.5%) [54] and heart (n = 1, 2.5%) [51] transplant recipients. The most common clinical presentations in these transplant patients who presented with organ rejection post-COVID-19 infection were acute kidney injury (n = 14, 35%) [12,16,47,49,55,60], periphera...…”

“…Allograft rejections after COVID-19 infection occurred in kidney (n = 30, 75%) [12,13,16,[46][47][48][49]53,55,57,60], cornea (n = 6, 15%) [14,15,50,56,59], lung (n = 2, 5%) [52,58], liver (n = 1, 2.5%) [54] and heart (n = 1, 2.5%) [51] transplant recipients. The most common clinical presentations in these transplant patients who presented with organ rejection post-COVID-19 infection were acute kidney injury (n = 14, 35%) [12,16,47,49,55,60], peripheral oedema (n = 6, 15%) [12,46,47,49], worsened vision (n = 6, 15%) [14,15,50,56,59], eye redness (n = 4, 10%) [14,15,56,59], reduced urine output (n = 2, 5%) [47,53], respiratory failure (n = 2, 5%) [52,58], eye discomfort (n = 2, 5%) [56,59] and conjunctivitis (n = 2, 5%)…”