مديريت همه گیری کرونا ویروس
Abstract
Resumen
Palabras clave
Introduction
General considerations in kidney transplant patients
Specific considerations regarding donation and transplantation
General recommendations for kidney transplant patients
Specific recommendations for kidney transplant patients suspected of SARS-CoV-2 infection
Treatment of SARS-CoV-2 disease
Immunosuppressive treatment in patients with SARS-CoV-2 disease
Key concepts
Financing
Conflict of interests
References
Abstract
The SARS-CoV-2 (Covid-19) coronavirus pandemic is evolving very quickly and means a special risk for both immunosuppressed and comorbid patients. Knowledge about this growing infection is also increasing although many uncertainties remain, especially in the kidney transplant population. This manuscript presents a proposal for action with general and specific recommendations to protect and prevent infection in this vulnerable population such as kidney transplant recipients.
Introduction
On December 31, 2019, the Wuhan Health Commission reported about groups of people with pneumonia who were epidemiologically linked to a seafood and live animal market in Wuhan, China.1 The etiology was identified as a new coronavirus, with a supposed zoonotic origin. The virus has been recently named the coronavirus of severe acute respiratory syndrome type 2 (SARS-CoV-2) and the disease has been called Coronavirus Disease 2019 (COVID-19).2 So far, there is uncertainty regarding the transmission capacity of the virus. Recent studies show the presence of a high viral load in the oropharynx at early stages of the disease, which increases the concern about the high risk of infectivity during incubation periods or with only mild symptoms.3 The average incubation period has been estimated to be 5–۶ days, with a range of 1–۱۴ days. In over 80% of cases the symptoms ofthe disease are mild (fever, cough, expectoration, general malaise), while approximately 20% may have serious clinical manifestations (pneumonia and other clinical complications) that require hospital admission. Pregnant women, newborns, the elderly, immunocompromised and patients with comorbidities such as diabetes mellitus, hypertension and cardiovascular disease, are more to be infected by COVID19, and they are more likely to suffer severe illness that often requires to be admitted to ICU. The impact of COVID-19 on chronic kidney disease has been scantily reported.4 Current mortality rate in China is 3.9% of the cases confirmed by the lab, which is very similar to that of Spain 3.7% (data as of March 16, 2020).5 However, it is still premature to establish the true mortality rate in our country.