Abstract
Objectives: Knowledge about the impact of coronavirus disease 2019 (COVID-19) on kidney transplant recipients (KTRs) concerning viral shedding and humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is limited. The aim of this study is to analyze viral dynamics and the antibody response to SARS-CoV-2 in KTRs with COVID-19 and study their association with clinical data.
Materials and methods: Consecutive KTRs diagnosed with COVID-19 at our center were evaluated for clinical presentation and outcome; duration of viral shedding and viral burden by reverse transcription-polymerase chain reaction assay cycle threshold; and magnitude of seroconversion to SARS-CoV-2.
Results: Six KTRs identified with COVID-19 were hospitalized. Presenting symptoms were similar to those in the general population. Four patients had severe disease and, of these, 2 required mechanical ventilation, 4 had acute kidney injury, and 3 had secondary bacterial infections. Immunosuppression was reduced in all patients. Five patients were treated with hydroxychloroquine. No patient required dialysis or died. Patients with severe disease had a longer duration of viral shedding, which lasted more than 40 days, and had IgG antibodies against SARS-CoV-2, which were detected from 3 weeks to as long as 10 weeks after symptom onset. In patients with less severe disease no IgG antibodies where detected between 9 and 14 weeks after symptom onset.
Conclusions: In our series, KTRs with severe COVID-19 had prolonged viral shedding and a stronger humoral immune response to SARS-CoV-2. These preliminary data need to be confirmed with further studies and over a longer period of time.
【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Hospitalized, Hydroxychloroquine, severe COVID-19, mechanical ventilation, Antibody Response, viral shedding, Immunosuppression, Acute kidney injury, severe acute respiratory syndrome Coronavirus, dialysis, polymerase chain reaction, Seroconversion, IgG antibody, Viral, IgG antibodies, Patient, viral dynamics, reverse transcription, humoral immune response, General population, Secondary bacterial infections, respiratory, prolonged viral shedding, Bacterial infections, patients, kidney transplant recipient, association, Reverse transcription-polymerase chain reaction, kidney transplant recipients, severe disease, Chain Reaction, presenting symptoms, presenting symptom, symptom onset, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, Clinical data, Preliminary data, material, viral burden, died, evaluated, required, treated, less, magnitude, concerning, the antibody response, was reduced, diagnosed with COVID-19, with COVID-19, 【제목키워드】 SARS-CoV-2, Transplant, response, recipient,