How we treated a kidney transplant recipient who was receiving sirolimus during the SARS-CoV-2 pandemic? primum non nocere”

Yıl 2022, , 345 - 348, 30.06.2022

Hamad Dheir , Didar Şenocak , Savaş Sipahi , Yasemin Gündüz , Selcuk Yaylacı , Necattin Fırat , Ahmed Bilal Genç , Mehmet Köroğlu , Oğuz Karabay

https://doi.org/10.31832/smj.783277

Öz

The new Coronavirus SARS-CoV-2 (COVID-19) epidemic continues to affect the world. It is emphasized that COVID-19 is more severe in patients with solid organ transplantation, and the risk of mortality may be higher than in the normal population. Herein, with the first time, we described a COVID-19 pneumoniae kidney recipient case treated with sirolimus. A 49-year-old male patient had kidney transplantation 13 years ago. He was used prednisolone and sirolimus. His main complaints were fever (38.3°C) and weakness. Atypical pneumoniae was diagnosed with thorax computed tomography. The respiratory specimen of the patient was positive with COVID-19 by PCR test. Sirolimus was stopped due to the immunosuppressive effect, and the treatment switched to low dose everolimus. Also, hydroxychloroquine, oseltamivir and azithromycin triple therapy was started for five days. The patient was discharged with healing on the seventh day.

Anahtar Kelimeler

COVID-19, Kidney transplantation,, Sirolimus

How We Treated a Kidney Transplant Recipient Who Was Receiving Sirolimus During the SARS-CoV-2 Pandemic? Primum Non Nocere

Öz

The new Coronavirus SARS-CoV-2 (COVID-19) epidemic continues to affect the world. It is emphasized that COVID-19 is more severe in patients with solid organ transplantation, and the risk of mortality may be higher than in the normal population. Herein, with the first time, we described a COVID-19 pneumoniae kidney recipient case treated with sirolimus. A 49-year-old male patient had kidney transplantation 13 years ago. He was used prednisolone and sirolimus. His main complaints were fever (38.3°C) and weakness. Atypical pneumoniae was diagnosed with thorax computed tomography. The respiratory specimen of the patient was positive with COVID-19 by PCR test. Sirolimus was stopped due to the immunosuppressive effect, and the treatment switched to low dose everolimus. Also, hydroxychloroquine, oseltamivir and azithromycin triple therapy was started for five days. The patient was discharged with healing on the seventh day.

Kaynakça

• [1] Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506.
• [2] Fei Zhou, Ting Yu, Ronghui Du, Guohui Fan, Ying Liu, Zhibo Liu, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062.
• [3] Gandolfini I, Delsante M, Fiaccadori E, Zaza G, Manenti L, Degli Antoni A, et al. COVID-19 in Kidney Transplant Recipients. Am J Transplant. 2020 Jul;20(7):1941-1943.
• [4] Zhang H, Chen Y, Yuan Q, Xia Q-X, Zeng X-P, Peng J-T, et al. Identification of Kidney Transplant Recipients with Coronavirus Disease 2019. Eur Urol. 2020 Jun;77(6):742-747.
• [5] Guillen E, Pineiro GJ, Revuelta I, Rodriguez D, Bodro M, Moreno A, et al. Case report of COVID-19 in a kidney transplant recipient: Does immunosuppression alter the clinical presentation? Am J Transplant. 2020 Jul;20(7):1875-1878.
• [6] Weiner SM, Sellin L, Vonend O, Schenker P, Buchner NJ, Flecken M, et al. Pneumonitis associated with sirolimus: clinical characteristics, risk factors and outcome--a single-centre experience and review of the literature. Nephrol Dial Transplant 2007;22:3631–7.
• [7] Almeida F, Amorim S, Sarmento A, Santos L. Life-Threatening Everolimus-Associated Pneumonitis: A Case Report and a Review of the Literature. Transplant Proc. 2018 Apr;50(3):933-938.
•   [8] Lee HS, Huh KH, Kim YS, Kim MS, Kim HJ, Kim SI, et al. Sirolimus-induced pneumonitis after renal transplantation: a single-center experience. Transplant Proc 2012;44:161–3.
• [9] Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19). StatPearls, Treasure Island (FL): StatPearls Publishing; 2020