Protracted COVID ‐19 pneumonitis early post‐ABO incompatible kidney transplantation: Management considerations and the role of whole genome sequencing

We present the case of a recent ABO incompatible kidney transplant recipient with persistent SARS‐CoV‐2 infection and pneumonitis. Serial whole genome sequencing confirmed intra‐host viral evolution, which was used as a surrogate to confirm active viral replication and support re‐treatment with anti...

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Bibliographic Details
Published in:Nephrology (Carlton, Vic.) Vic.), 2023-11, Vol.28 (11), p.639-643
Main Authors: Stoler, Sara, van Hal, Sebastiaan J., Chadban, Steve, Le, Thomas, Torzillo, Paul, Scarlato, Rose‐Marie, Wyburn, Kate, Perkins, Griffith B., Marinelli, Tina
Format: Article
Language:English
Subjects:
ABO system
Antiviral agents
COVID-19
Genomes
Immunosuppression
Kidney transplantation
Pneumonitis
Severe acute respiratory syndrome coronavirus 2
Whole genome sequencing
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Summary:We present the case of a recent ABO incompatible kidney transplant recipient with persistent SARS‐CoV‐2 infection and pneumonitis. Serial whole genome sequencing confirmed intra‐host viral evolution, which was used as a surrogate to confirm active viral replication and support re‐treatment with antivirals, late in the course of infection. A prolonged course of remdesivir combined with immunosuppression modulation resulted in successful clearance of virus and clinical improvement. The diagnostic process undertaken in this case provides a useful guide for other clinicians when approaching similar patients.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.14235