There is no consensus on the management of COVID-19 and modification of immunosuppressive therapy in kidney transplant recipients (KTRs). In this study, we examined the clinical outcome of our KTRs with Covid-19 disease, who were treated with a broad-spectrum antiinflammatory protocol.
Among 809 KTRs, 64 patients diagnosed with Covid-19 disease between April 2020 and February 2021,were evaluated. 29 patients with pneumonia confirmed by chest computed tomography (CCT), were hospitalized. The treatment protocol included high dose intravenous methylprednisolone, favipiravir,enoxaparin and an empirical antibiotics. Patients with pneumonic involvement of more than 25% on CCT with or without respiratory failure,were given a total of 2 g/kg intravenous immunoglobulin (IVIg) therapy. Non-responders received tocilizumab, an IL-6 receptor antibody.
Of the 29 patients with pneumonia, 6 were treated in other hospitals. None of them received IVIg and 5 of them deceased. In our center, IVIg treatment was applied to 15 of 23 patients. 7 of them required tocilizumab. Respiratory parameters improved significantly in all but one patients after IVIg ± tocilizumab treatment. The mortality rate was 6.6% in patients who received IVIg therapy and 35.7% in those who did not (p = 0.08). Mortality rate was higher in patients who received treatment in external centers (2.2% vs 26.3%; p=0.0073).
The treatment of KTRs with severe Covid-19 pneumonia in organ transplant centers with significant experience yields better results. The administration of broad-spectrum anti-inflammatory treatment in this patient group was safe and provided excellent outcomes. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.