Angelico R, Framarino-dei-Malatesta ML, Iaria G. COVID-19 in a pregnant kidney transplant recipient - what we need to know: A case report. World J Transplant 2022; 12(10): 325-330 [PMID: 36313235 DOI: 10.5500/wjt.v12.i10.325]
Corresponding Author of This Article
Roberta Angelico, FEBS, MD, PhD, Assistant Professor, Department of Surgical Sciences, HPB and Transplant Unit, University of Rome Tor Vergata, Viale Oxford 31, Rome 00100, Italy. roberta.angelico@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Oct 18, 2022; 12(10): 325-330 Published online Oct 18, 2022. doi: 10.5500/wjt.v12.i10.325
COVID-19 in a pregnant kidney transplant recipient - what we need to know: A case report
Roberta Angelico, Maria Luisa Framarino-dei-Malatesta, Giuseppe Iaria
Roberta Angelico, Department of Surgical Sciences, HPB and Transplant Unit, University of Rome Tor Vergata, Rome 00100, Italy
Maria Luisa Framarino-dei-Malatesta, Department of Gynecologic-Obstetrical and Urologic Sciences, Policlinico Umbero I, Sapienza University of Rome, Rome 00100, Italy
Giuseppe Iaria, Kidney Transplant Unit, San Camillo Forlanini, Rome 00100, Italy
Author contributions: Angelico R contributed to the study conception and design, writing; Framarino-dei-Malatesta ML was involved in the acquisition of clinical data, analysis, and interpretation; Iaria G contributed to the study conception; and all authors were involved in critical revision.
Informed consent statement: Informed consent was obtained from the patient for publication of their information.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roberta Angelico, FEBS, MD, PhD, Assistant Professor, Department of Surgical Sciences, HPB and Transplant Unit, University of Rome Tor Vergata, Viale Oxford 31, Rome 00100, Italy. roberta.angelico@gmail.com
Received: April 5, 2022 Peer-review started: April 5, 2022 First decision: May 31, 2022 Revised: June 7, 2022 Accepted: September 7, 2022 Article in press: September 7, 2022 Published online: October 18, 2022 Processing time: 194 Days and 15.9 Hours
Abstract
BACKGROUND
In the era of the coronavirus disease 2019 (COVID-19) pandemic, kidney transplant recipients are more susceptible to severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection, developing severe morbidity and graft impairment. Pregnant women are also more likely to develop severe COVID-19 disease, causing pregnancy complications such as preterm births and acute kidney injury.
CASE SUMMARY
Herein, we report the case of a pregnant woman with a third kidney transplantation who developed COVID-19 disease. The reduction of immunosuppressive drugs and strict monitoring of trough blood levels were needed to avoid severe SARS-CoV-2-related complications, and permitted to continue a healthy pregnancy and maintain good graft function. In such a complex scenario, the concomitance of COVID-19-related morbidity, the risk of acute rejection in the hyperimmune recipient, graft dysfunction and pregnancy complications make the management of immunosuppression a very difficult task and clinicians must be aware.
CONCLUSION
Tailoring the immunosuppressive regimen is a key factor affecting both the graft outcome and pregnancy safety.
Core Tip: Kidney transplant (KT) recipients are susceptible to coronavirus disease 2019 (COVID-19). Pregnant women are more likely to develop severe COVID-19, causing pregnancy complications such as preterm births and acute kidney injury. The management of immunosuppression in pregnant KT recipients with severe acute respiratory syndrome coronavirus infection is crucial for the avoidance of severe morbidity to the patient and the fetus, and to escape renal graft dysfunction.
