Diagnosis and treatment of novel coronavirus pneumonia after kidney transplant: a report of 2 cases/ 肾移植术后新型冠状病毒肺炎二例诊疗体会

Objective To analyze novel coronavirus (2019-nCoV) infection after kidney transplant and its clinical features Method we reviewed medical history, laboratory values, chest CT, treatments and clinical outcomes of two cases confirmed with COVID-19 after kidney transplant, admitted to The First Affiliated Hospital of Zhengzhou University in February 2020 Both cases were middle-aged males and confirmed COVID-19 11 or 12 months after transplantation They both started with moderate to low fever with cough and fatigue Chest CT showed multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary They all combined with varying degrees of renal function and cardiac insufficiency Result In case 1, the application of immunosuppressants was reduced while the dosage of glucocorticoids was increased during treatment In case 2, the amount of immunosuppressants was not reduced, and CRRT was performed 3 times in the early course of the disease due to renal insufficiency and hyperkalemia Both cases were treated with oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy and prevention of infection, anti-inflammatory treatment, and both were cured Conclusions The clinical manifestations and diagnosis of patients with COVID-19 after kidney transplant are not significantly different from those of other people, but early renal function and heart function abnormalities occur How to adjust the immunosuppressant in the course of severe COVID-19 treatment in renal transplantation patient needs to be further explored