The course of SARS-CoV-2 in a patient after a recent kidney transplantation – a literature review on COVID-19 therapy

Abstract Introduction Kidney transplant recipients are at high risk of severe complications and death due to coronavirus disease (COVID-19). Methods First part of the paper describes a case of COVID-19 in our patient after recent kidney transplantation. Second and third part of the paper is an outcome of literature search from multiple resources from April 2020 till March 2021. Abstracts were screened, followed by full-text review with data extraction. Part two discusses current treatment options of COVID-19 and part three refers to this treatment application in patients after solid organ transplantation. Results We have summarized 45 studies from China, France, Italy, Spain, United Kingdom, and United States. Mortality rates from published studies were variable. Based on early data early from Spain, 42% of patients who developed COVID-19 within 60 days of transplantation died. According to results of the ERACODA collaboration group the 28-day COVID-19-related mortality is 21.3% in kidney transplant which is still markedly higher than what is observed in other populations. Acute kidney injury was common, and mycophenolate mofetil and mTOR were discontinued in most patients. Conclusion Effective therapy has been sought since the outbreak of the pandemic, and at the same time intensive work has been underway to produce a vaccine that could effectively protect against the disease. Summing up the efforts of numerous groups of researchers from around the world that have been continued since the beginning of 2020, we may assume the following:  -We still do not have causal drugs that would reduce SARS-CoV-2 replication and allow its complete elimination, but anti-spike monoclonal antibodies against SARS-CoV-2 seem to be very promising.  -The withdrawal of antiproliferative and antimetabolic drugs and the continuation of steroids and CNI inhibitors is nowadays a commonly accepted approach in patients after an organ transplantation.