- Cases of kidney transplantation patients infected with Corona virus-19 on steroidal therapy
| Type of study/Ref | Age (y) | N | G | Time from transplantation (y) | Maintenance IS | Continued steroid? | Setting | Outcomes |
|---|---|---|---|---|---|---|---|---|
| Cohort trial5 | 51-64 | 20 | M, F | Median 13 | Withdrawn all IS started on methylpred 16 mg | Yes | 6 mild hospitalized 10 severe, 4 critical (ICU) | 6 patients developed AKI 5 patients died |
| Case report13 | 65 | 1 | M | Unknown | TAC, MMF, Pred | Yes | Severe ICU | Recovery after 10 days |
| Case series14 | 21 | 8 | F | 0.3 | TAC, Pred | Yes | Inpatient | Recovery Discharged after 2 days |
| 71 | M | 3 | TAC, Pred | Yes | Inpatient | Discharged after 2 days with stable kidney function | ||
| 50 | M | 0.2 | TAC reduced dose, Pred | Yes | Self-isolation | Full recovery | ||
| 63 | M | 15 | TAC, Pred | Yes | Inpatient | Recovery discharged after 7 days | ||
| 47 | F | 0.4 | TAC, Pred | Yes | Severe ICU | AKI recovery, discharged after 21 days | ||
| 71 | F | 15 | TAC, Pred | Yes | Inpatient | Discharged after 4 days with full recovery | ||
| 40 | F | 3 | ||||||
| 38 | M | 6 | TAC reduced dose, Pred | Yes | Discharged after 2 days | |||
| Systematic review15 | 31-75 | 554 | M, F | Range: 0-25 | CNI: withdrawn in 31.9%, reduced in 19.7% AD: withdrawn in 75.3%, reduced in 9.5% 72% were on Pred | Yes | Ranging from home isolation to ICU admission | Renal graft function remained stable in 76.17% of patients, whereas 8.84% experienced graft loss and 1.44% developed AKI. 21.84% of patients died |
| Case report16 | 29 | 1 | M | 1.2 | Cyclosporin, MMF, methylpred | Yes | Inpatient | Recovery after 13 days |
| Case report17 | 61 | 1 | F | 16 | MMF, Pred | Yes | Inpatient | Recovery after 5 days |
| Case report18 | 52 | 1 | M | 12 | D/C all IS. Started on methylpred 40 mg | Yes | Inpatient | Recovery discharge after 13 days |
| Case report19 | 50 | 1 | M | 4 | Pred continued TAC and everolimus withdrawn | Yes | ICU | Still in ICU at time of report |
| Case report20 | 75 | 2 | M | 10 | TAC, MMF: D/C Pred | Yes | Severe inpatient | Died after 5 days |
| 52 | F | 0.8 | AKI discharge on day 14 | |||||
| Case report21 | 58 | 1 | M | 11 | MMF and steroid | Yes | Severe ICU | Died with multiorgan dysfunction |
| Case report22 | 32 | 1 | M | 2 | MMF, increased dose Pred, TAC | Yes | Inpatient | AKI resolution and discharge |
| Case report23 | 28 | 1 | F | 0.5 | MMF, TAC, Pred | Yes | Mild inpatient | Discharged with full recovery |
| Case report24 | 54 | 1 | M | 5 | DC TAC, Pred, EVE, continued on methypred 40 mg IV daily | Yes | Severe ICU | Discharged after 49 days |
| Systematic review25 | 21-80 | 561 | M, F | 0-31 | Outcome n=144: 84 patients increase steroid dose, 6 patients either reduced or DC, 45 patients with no change | Variable | 73 severe inpatients 40 ICU | Outcome reported for 144 patients: 74 patients discharged 36 improved still in hospital, 34 died |
| Cohort study26 | 53.8 ±13.5 | 38 | M, F | Median 5.8 | 84.2% on TAC, 89.5% on MMF, 81.6% on Pred. Adjunct steroid boluses were provided for ARDS | Yes | 38 hospitalized: 20 severe ICU | 27 patients survived 11 patients died |
Ref: reference, N: number of patients, G: gender, M: male, F: female, IS: immunosuppression, ICU: intensive care unit, MMF: mycophenolate mofetil, TAC: Tacrolimus, Pred: prednisolone, CNI: calcineurin inhibitors either tacrolimus or cyclosporin, AD: antimetabolite drugs including mycophenolate and azathioprine, AKI: acute kidney injury, D/C: Discontinued, methylpred: methylprednisolone, EVE: everolimus, ARDS: acute respiratory distress syndrome, IV: intravenous