Severe COVID-19 infection in a kidney transplant recipient treated with lopinavir/ritonavir, hydroxychloroquine and dexamethasone

  • Satriyo Dwi Suryantoro Department of Internal Medicine, Faculty of Medicine Airlangga University, Airlangga University Hospital, Surabaya, Indonesia https://orcid.org/0000-0002-0522-8659
  • Mochammad Thaha Department of Internal Medicine, Faculty of Medicine Airlangga University, Airlangga University Hospital, Surabaya, Indonesia
  • Pranawa Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Djoko Santoso Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Nunuk Mardiana Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Widodo Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Aditiawardana Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Artaria Tjempakasari Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Ardityo Rahmat Ardhany Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia https://orcid.org/0000-0001-5838-5706
  • Dana Pramudya Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Decsa Medika Hertanto Department of Internal Medicine, Faculty of Medicine Airlangga University, General Teaching Hospital Dr. Soetomo, Surabaya, Indonesia
  • Evy Febriane Premier Hospital Surabaya, Surabaya, Indonesia
  • Meryana Premier Hospital Surabaya, Surabaya, Indonesia
  • Maria Angela Premier Hospital Surabaya, Surabaya, Indonesia
  • Ari Christy Muliono Premier Hospital Surabaya, Surabaya, Indonesia
  • Handoko Tanuwidjaja Premier Hospital Surabaya, Surabaya, Indonesia
  • Philia Setiawan Premier Hospital Surabaya, Surabaya, Indonesia
  • David Sugiarto Premier Hospital Surabaya, Surabaya, Indonesia
Keywords: kidney transplant, immunosupressive drugs, lopinavir, ritonavir, hydroxycholorquine

Abstract

Severe COVID-19 infection management for a recipient of kidney transplant has debatable prognosis and treatment. We described the case of a COVID-19 infected 70 year old female, previously had renal transplantation in 2017. The patient took immunosuppressive agents as routine drugs for transplant recipient status and received lopinavir/ritonavir, hydroxychloroquine, and dexamethasone daily at the hospitalization. Specific question arises about renal transplant recipients being infected by COVID-19 – whether the infection will get worse compared to those without immunosuppresive agent. In this case, author decided to stop the immunosuppressive agent followed administration of combination lopinavir/ritonavir, hydroxychloroquine, and dexamethasone that gives a good clinical impact change to patient’s condition after once getting worsened and mechanically ventilated. Nevertheless, the assessment of risk and benefit in continuing immunosuppressive drugs is concurrently essential due to the prevention of transplant rejection.

Published
2021-09-30
How to Cite
1.
Suryantoro SD, ThahaM, Pranawa, SantosoD, MardianaN, Widodo, Aditiawardana, Tjempakasari A, Ardhany AR, Pramudya D, Hertanto DM, Febriane E, Meryana, Angela M, Muliono AC, Tanuwidjaja H, Setiawan P, Sugiarto D (2021) Severe COVID-19 infection in a kidney transplant recipient treated with lopinavir/ritonavir, hydroxychloroquine and dexamethasone. J Infect Dev Ctries 15:1257-1262. doi: 10.3855/jidc.14952
Section
Coronavirus Pandemic