Severe COVID-19 in 2 Kidney Transplant Patients in Gabon

Abstract

Rare coexistence of disease or pathology Background:Kidney failure is a public health problem that may require transplantation for patient survival and for those at risk of developing infectious diseases such as COVID-19 due to severe immunosuppression. We report the case of 2 kidney transplant patients who contracted COVID-19. Case Reports:Patient 1: A 60-year-old Gabonese man presented with 8 days of wet cough, fever, and myalgias associated secondarily with dyspnea, without anosmia or ageusia. His medical history included renal transplant for malignant nephro-angiosclerosis and high blood pressure. The oxygen saturation level subsequently fell to 89-90%.The diagnosis of acute hypoxic respiratory failure secondary to COVID-19 pneumonia with heart and acute renal failure on renal transplant was made based on clinical symptoms, lung imaging results, and a positive SARS-CoV-2 nasal swab PCR test. Patient 2: A 79-year-old Gabonese man presented with 10 days of dry cough associated with intermittent fevers not quantified, anorexia, and fatigue. The patient's medical history was high blood pressure, diabetes mellitus, and renal transplantation. Oxygen saturation level decreased to 85-89% in ambient air. Clinical signs and chest CT scan showed 70% lung lesions with large areas of ground-glass opacity with essentially peripheral distribution of both lungs associated with crazy paving, condensation, bronchiectasis, and arterial dilatation, suggesting severe COVID-19. Conclusions:Those 2 presentations highlight the fact that a severe clinical form of COVID-19 associated with acute renal failure and kidney transplant can be fatal. Kidney transplantation is a risk factor for poor prognosis in patients with severe COVID-19 and greatly worsens the mortality rate of immunocompromised patients.

Cancer Care During the COVID-19 Pandemic: The African Narrative and Prospects

“…Furthermore, the closure of country borders and movement restrictions posed logistic constraints resulting in the dearth of medications and clinical supplies requisite to cancer care delivery. Lastly, many oncological patients were prevented from visiting health facilities due to heightened fear of the COVID-19 virus [10,11] especially because they are at high risk for the acute form of the viral illness and fatal outcomes from reduced immunity caused by the malignancy itself, or consequent to radiotherapy, chemotherapy, [12] and surgeries [13] used in the management of persons with cancer. Telemedicine, small unmanned aerial systems (sUAS), and home therapy [14][15][16] are the most significant alternative care methods implemented across Africa during the peak of the pandemic to facilitate cancer services.…”