A Kidney Transplant Patient Who Died of COVID-19-associated Severe Acute Respiratory Distress Syndrome: A Case Report

Akinari Tsukada; Manabu Suzuki; Yuya Kishino; Kento Misumi; Toru Igari; Noriko Nakajima; Yuko Sato; Tadaki Suzuki; Takashi Katsuno; Yusaku Kusaba; Yoshie Tsujimoto; Keita Sakamoto; Masao Hashimoto; Junko Terada; Jin Takasaki; Shinyu Izumi; Masayuki Hojo; Haruhito Sugiyama

doi:10.2169/internalmedicine.7089-21

This article has now been updated. Please use the final version.

A Kidney Transplant Patient Who Died of COVID-19-associated Severe Acute Respiratory Distress Syndrome: A Case Report

Akinari Tsukada, Manabu Suzuki, Yuya Kishino, Kento Misumi, Toru Igari, Noriko Nakajima, Yuko Sato, Tadaki Suzuki, Takashi Katsuno, Yusaku Kusaba, Yoshie Tsujimoto, Keita Sakamoto, Masao Hashimoto, Junko Terada, Jin Takasaki, Shinyu Izumi, Masayuki Hojo, Haruhito Sugiyama

Author information

Akinari Tsukada
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Manabu Suzuki
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Yuya Kishino
Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
Kento Misumi
Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
Toru Igari
Department of Diagnostic Pathology, National Center for Global Health and Medicine, Japan
Noriko Nakajima
Department of Pathology, National Institute of Infectious Diseases, Japan
Yuko Sato
Department of Pathology, National Institute of Infectious Diseases, Japan
Tadaki Suzuki
Department of Pathology, National Institute of Infectious Diseases, Japan
Takashi Katsuno
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Yusaku Kusaba
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Yoshie Tsujimoto
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Keita Sakamoto
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Masao Hashimoto
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Junko Terada
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Jin Takasaki
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Shinyu Izumi
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Masayuki Hojo
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Haruhito Sugiyama
Department of Respiratory Medicine, National Center for Global Health and Medicine, Japan

Keywords: COVID-19, SARS-CoV-2, kidney transplant, immunosuppressed

JOURNAL OPEN ACCESS Advance online publication

Article ID: 7089-21

DOI https://doi.org/10.2169/internalmedicine.7089-21

The final version of this article is now available: Vol. 60 (2021), No. 14 pp. 2297-2300

Details

Abstract

We herein report a 67-year-old kidney transplant patient who died of COVID-19. He was treated with hydroxychloroquine and azithromycin and received mechanical ventilation that temporarily improved his respiratory status. Despite our efforts, however, he later developed respiratory failure and died 43 days after the disease onset. The autopsy revealed prominent organization of alveoli and alveolar ducts, with a massive accumulation of macrophages in the lungs. A few SARS-CoV-2 antigen-positive cells were detected in the lung, suggesting delayed virus clearance owing to his long-term immunosuppressed state, leading to constant lung damage and ultimately respiratory failure.

Corresponding author

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