Viral shedding prolongation in a kidney transplant patient with COVID-19 pneumonia

Zhang, Man; Zhang, Jing; H, Shi; Liu, Bin; Zeng, Fanjun

doi:10.1111/ajt.15996

Cited by 43 publications

(44 citation statements)

References 5 publications

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“…Hydroxychloroquine sulfate and chloroquine phosphate, historically, anti-malaria drugs, have also been investigated for treatment of COVID-19 in clinical trials. 64,65 In the current study, hydroxychloroquine was used in 54.8% (121/221) of KTx patients, most frequently in those with severe symptomatology [18][19][20][21]24,27,28,[30][31][32]34,[36][37][38][39][40][41][43][44][45][46][47][48]51 , and umifenovir, alone or in combination. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41]…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 76%

“…Laboratory evaluation was included in 33 of 37 studies. 18,19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41][42][43][44]46,[48][49][50][51][52][53][54] Most patients presented with lymphopenia appears to be self-limited and its clinical implications are not well described in the literature. 60 Regarding radiographic findings in KTx COVID-19-infected patients, 78.5% presented with bilateral ground-glass opacities in both chest plain radiograph and CT scan of the chest.…”

Section: Symptomatology and Laboratory Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Moris

Kesseli

Barbas

2020

Transplant Infectious Dis

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There is an accumulating body of literature surrounding the impact of COVID‐19 infection in solid organ transplant recipients. The aim of this review is to summarize the existing literature specifically in kidney transplant (KTx) recipients, with an emphasis on the epidemiology, clinical presentation, laboratory findings, post‐operative outcomes and therapeutic strategies currently employed. We identified thirty‐seven studies published between January 1 st 2020 to June 10 th 2020 that were included in our analysis. As is reported in the general population, there is a wide variation in COVID‐19 presentation among KTx patients, ranging from asymptomatic to life‐threatening end‐organ failure. The most common symptoms are predominantly respiratory and associated with fever. On lab evaluation, many patients present with lymphopenia and increased CRP, which are both associated with inferior outcomes. The majority of patients with severe symptoms have been managed with reduction of immunosuppression, including decreased doses of CNIs and withdrawal of MMF. Lastly, although there is no high‐level data supporting the use of immunomodulatory drugs, such as IL‐6 inhibitors, early experiences have suggested these drugs may improve outcomes in KTx patients with severe COVID‐19.

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Section: Ta B L E 2 (Continued)mentioning

confidence: 76%

Section: Symptomatology and Laboratory Findingsmentioning

confidence: 99%

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Moris

Kesseli

Barbas

2020

Transplant Infectious Dis

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“…First, there is concern that organ transplant recipients may be at a greater risk for acquiring and experiencing worse clinical outcomes due to COVID-19 infection [5][6][7]. Second, immunosuppressed KT recipients may have prolonged viral shedding and transmissibility, potentially posing a greater risk to public health [8,9]. Third, there is concern that hospitals will not have the resources to safely perform KT and provide the necessary postoperative care [10].…”

Section: Introductionmentioning

confidence: 99%

Effects of COVID-19 pandemic on pediatric kidney transplant in the United States

et al. 2020

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Background In March 2020, COVID-19 infections began to rise exponentially in the USA, placing substantial burden on the healthcare system. As a result, there was a rapid change in transplant practices and policies, with cessation of most procedures. Our goal was to understand changes to pediatric kidney transplantation (KT) at the national level during the COVID-19 epidemic. Methods Using SRTR data, we examined changes in pediatric waitlist registration, waitlist removal or inactivation, and deceased donor and living donor (DDKT/LDKT) events during the start of the disease transmission in the USA compared with the same time the previous year. Results We saw an initial decrease in DDKT and LDKT by 47% and 82% compared with expected events and then a continual increase, with numbers reaching expected prepandemic levels by May 2020. In the early phase of the pandemic, waitlist inactivation and removals due to death or deteriorating condition rose above expected values by 152% and 189%, respectively. There was a statistically significant decrease in new waitlist additions (IRR 0.49 0.65 0.85) and LDKT (IRR 0.17 0.38 0.84) in states with high vs. low COVID activity. Transplant recipients during the pandemic were more likely to have received a DDKT, but had similar calculated panel-reactive antibody (cPRA) values, waitlist time, and cause of kidney failure as before the pandemic. Conclusions The COVID-19 pandemic initially reduced access to kidney transplantation among pediatric patients in the USA but has not had a sustained effect.

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“…These two patients finally transferred to ARDS (Acute respiratory distress syndrome), and eventually died after [10]. Among the immunocompromised patients, Zhang et al [11] reported a patient with kidney transplantation who had a prolonged viral shedding duration for 63 days. This is the first report of a patient co-infected with HIV and SARS-CoV-2 who showed a prolonged viral shedding duration.…”

Section: Discussionmentioning

confidence: 99%

Case report: one case of coronavirus disease 2019 (COVID-19) in a patient co-infected by HIV with a normal CD4+ T cell count

Zheng

Liu

et al. 2020

AIDS Res Ther

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Background: The COVID-19 has been a severe pandemic all around the world. Nowadays the patient with co-infection of HIV and SARS-CoV-2 was rarely reported. Here we reported a special case with HIV and SARS-CoV-2 co-infection, which showed a prolonged viral shedding duration. Case presentation: The patient was infected with HIV 8 years ago through sexual transmission and had the normal CD4 + T cell count. She was found SARS-CoV-2 positive using real-time Polymerase Chain Reaction (RT-PCR) during the epidemic. Most importantly, the patient had a prolonged viral shedding duration of SARS-CoV-2 about 28 days. Conclusion: The viral shedding duration may be prolonged in people living with HIV. The 14 days isolation strategy might not be long enough for them. The isolation or discharge of these patients needs further confirmation for preventing epidemics.

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Viral shedding prolongation in a kidney transplant patient with COVID-19 pneumonia

Cited by 43 publications

References 5 publications

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Kidney transplant recipients infected by COVID‐19: Review of the initial published experience

Effects of COVID-19 pandemic on pediatric kidney transplant in the United States

Case report: one case of coronavirus disease 2019 (COVID-19) in a patient co-infected by HIV with a normal CD4+ T cell count

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