Subscribe to RSS
DOI: 10.1055/s-0041-1725183
COVID-19 in an Asymptomatic Renal Transplant Recipient Employed in the Health Care Setting: A Case Report
Abstract
During the ongoing pandemic, there have been varying presentations of coronavirus disease 2019 (COVID-19) infection, with the concern that patients who are immunosuppressed (due to underlying medical conditions and/or therapies) are at higher risk of severe disease. We report the case of an elderly renal transplant recipient working in a long-term health care facility who was being monitored by weekly surveillance testing and tested positive for COVID-19 by polymerase chain reaction (PCR) testing, despite having no clinical symptoms. He recovered with supportive care, despite being on multiple long-term immunosuppressant drugs and having multiple comorbidities. Additionally, it was found that he did not mount an antibody response, when he tested negative by serologic testing. Through this case, we wish to highlight the unique clinical scenario of asymptomatic patients who may have an underwhelming immune response to COVID-19, but may nevertheless be an important source of dissemination. We further discuss the probable mechanism of such asymptomatic presentations in immunosuppressed patients, while reinforcing the importance of self-isolation of COVID-19 patients (particularly in asymptomatic health care workers).
Publication History
Article published online:
11 March 2021
© 2021. International College of Angiology. This article is published by Thieme.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223): 497-506
- 2 Vizcarra P, Pérez-Elías MJ, Quereda C. et al; COVID-19 ID Team. Description of COVID-19 in HIV-infected individuals: a single-centre, prospective cohort. Lancet HIV 2020; 7 (08) e554-e564
- 3 Nair V, Jandovitz N, Hirsch JS. et al. COVID-19 in kidney transplant recipients. Am J Transplant 2020; 20 (07) 1819-1825
- 4 Centers for Disease Control and Prevention, Coronavirus disease. 2019 (COVID-19):pPeople with certain medical conditions. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medicalconditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html. Accessed July 26, 2020
- 5 D'Antiga L. Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transpl 2020; 26 (06) 832-834
- 6 Nguyen LH, Drew DA, Joshi AD. et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. Preprint. Medrxiv 2020
- 7 Clarke C, Prendecki M, Dhutia A. et al. High prevalence of asymptomatic COVID-19 infection in hemodialysis patients detected using serologic screening. J Am Soc Nephrol 2020; 31 (09) 1969-1975
- 8 Qi L, Yang Y, Jiang D. et al. Factors associated with the duration of viral shedding in adults with COVID-19 outside of Wuhan, China: a retrospective cohort study. Int J Infect Dis 2020; 96: 531-537
- 9 Huff HV, Singh A. Asymptomatic transmission during the COVID-19 pandemic and implications for public health strategies. Clin Infect Dis 2020; ciaa654
- 10 Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395 (10229): 1033-1034
- 11 Centers for Diseases Control and Prevention, Coronavirus disease. 2019 (COVID-19): test for past infection. https://www.cdc.gov/coronavirus/2019-ncov/testing/serology-overview.html Accessed August 3, 2020
- 12 Zhao H, Lu X, Deng Y, Tang Y, Lu J. COVID-19: asymptomatic carrier transmission is an underestimated problem. Epidemiol Infect 2020; 148: e116
- 13 Centers for Diseases Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html . Accessed August 19, 2020
- 14 Pham TD, Huang C, Wirz OF. et al. SARS-CoV-2 RNAemia in a healthy blood donor 40 days after respiratory illness resolution. Ann Intern Med 2020; 173 (10) 853-854
- 15 Department of health, New York State Department of Health. Required COVID-19 testing for all nursing home and adult care facility personnel. https://www.health.ny.gov/professionals/hospital_administrator/letters/2020/docs/dal_20-14_covid_required_testing.pdf . Published May 11, 2020. Accessed August 4, 2020
- 16 Jones NK, Rivett L, Sparkes D. et al; CITIID-NIHR COVID-19 BioResource Collaboration. Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19. eLife 2020; 9: e59391