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Turk J Med Sci ; 51(2): 428-434, 2021 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-33185367

RESUMEN

Background/aim: We aimed to identify clinical settings of renal transplant patients with COVID-19. Materials and methods: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. Results: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients. Conclusion: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.


Asunto(s)
COVID-19/fisiopatología , Glucocorticoides/uso terapéutico , Rechazo de Injerto/prevención & control , Huésped Inmunocomprometido , Inmunosupresores/uso terapéutico , Trasplante de Riñón , Lesión Renal Aguda/fisiopatología , Lesión Renal Aguda/terapia , Adulto , COVID-19/inmunología , COVID-19/terapia , Deprescripciones , Dexametasona/uso terapéutico , Progresión de la Enfermedad , Everolimus/uso terapéutico , Femenino , Mortalidad Hospitalaria , Hospitalización , Humanos , Tiempo de Internación , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Ácido Micofenólico/uso terapéutico , Diálisis Renal , Respiración Artificial , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/terapia , Estudios Retrospectivos , SARS-CoV-2 , Sepsis/fisiopatología , Tacrolimus/uso terapéutico
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