With the global spread of SARS-Cov-2 infections, increasing numbers of COVID-19 cases have been reported in transplant recipients. However, reports are lacking concerning the treatment and prognosis of COVID-19 pneumonia in renal transplant recipients with acute cardiorenal syndrome. We report here the complete clinical course of a renal transplant recipient with critical COVID-19 pneumonia. In the early phase of SARS-Cov-2 infection, the patient exhibited extensive lung lesions and significant acute kidney and heart injuries, which required treatment in the ICU. After correcting the arrhythmia and heart failure, the patient recovered quickly from the acute kidney injury with a treatment of intensive diuresis and strict control of fluid intake. Without cessation of oral immunosuppressive agents, the patient presented a delayed and low antibody response against SARS-Cov-2 and reappeared positive for the virus twice after being discharged. Nevertheless, the patient’s pneumonia continued to improve and he fully recovered in 69 days. This effectively treated case may be meaningful and referable for the treatment of COVID-19 pneumonia in other transplant recipients with acute cardiorenal syndrome.
Cardiorenal Med

中文翻译：

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从免疫性抑制的肾移植早期急性肾综合征患者的冠状病毒2019年严重肺炎中恢复缓慢。

随着SARS-Cov-2感染的全球传播，在移植接受者中报告了越来越多的COVID-19病例。然而，关于急性心肾综合征肾移植受者中COVID-19肺炎的治疗和预后方面缺乏报道。我们在这里报告患有严重COVID-19肺炎的肾移植受者的完整临床过程。在SARS-Cov-2感染的早期阶段，患者表现出广泛的肺部病变以及严重的急性肾和心脏损伤，需要在ICU中进行治疗。在纠正了心律不齐和心力衰竭后，患者通过强化利尿和严格控制体液摄入的方法，从急性肾损伤中迅速康复。在不停止口服免疫抑制剂的情况下，该患者呈现出针对SARS-Cov-2的延迟且低抗体应答，出院后两次再次呈阳性。然而，患者的肺炎持续改善，他在69天内完全康复。该有效治疗的病例对于在其他患有急性心肾综合征的移植患者中治疗COVID-19肺炎可能是有意义和可借鉴的。
心肾医学