Successful Treatment of Severe Covid-19 in A Kidney Transplant Recipient With Tocilizumab


Kidney Transplant



We report a case of severe COVID?19 in a deceased donor kidney transplant recipient (KTR) who was successfully treated with Tocilizumab. She presented with COVID-19 symptoms and tested positive by reverse transcription real?time polymerase chain reaction (RT-PCR) of nasopharyngeal swab. The patient was admitted on day 5 of illness with chest radiography (CXR) suggestive of bronchopneumonia. Blood investigations showed leucocytosis with normal lymphocyte count and raised C-reactive protein (CRP). We closely monitored her condition as she was able to maintain saturation under room air. She deteriorated further on day 9 of illness, requiring withholding of immunosuppressive medications, increasing dose of oxygen therapy and dexamethasone. Tocilizumab was started for lymphopenia, raised lactate dehydrogenase (LDH) and persistence of alveolar opacities. Complications include acute kidney injury (AKI) and transaminitis. Her symptoms of pneumonia gradually improved, was able to be discharged on day 20 of illness, with complete resolution of AKI.



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