COVID-19 Infection in Simultaneous Pancreatic Kidney Transplant Recipients: Case Series and Literature Review

The severity of COVID-19 infection in transplant patients is much higher when compared to the general population. There are limited data on different organ transplants and their management strategies for COVID-19 infection. This is the first case series and literature review from Asia describing COVID-19 infection among simultaneous pancreatic and kidney transplant (SPK) recipients. This is a retrospective study of 5 patients who underwent SPK and contracted COVID-19 infection during the pandemic. Management was similar to the treatment strategies employed then because of the lack of conclusive data during the pandemic. This was compared with the existing literature. Mycophenolate was withheld in four patients (80%). Oral prednisolone was changed to intravenous steroid for the patients who required hospital admission (60%). Two patients had COVID-19 infection in the immediate postoperative period (40%), complicating hospital course and recovery. Out of five patients, one died due to severe sepsis and multiorgan failure. Graft function of both kidney and pancreas was stable in four out of five patients even in the follow up period. These patients' course was complicated by infections (3/4) in the post COVID-19 followup period, although the graft function was stable. Management of COVID-19 infection among SPK transplant recipients should always be individualized based on clinical, laboratory, andimaging parameters in toto as there is limited literature. The follow up period is crucial as there are high chances of opportunistic infections.