COVID-19 in post-transplantation patients- report of two cases.

Huang, Jiaofeng; Lin, Heng; Wu, Yinlian; Fang, Yingying; Kumar, Rahul; Chen, Gongping; Lin, Su

Coronavirus Disease 2019 (COVID-19) has become a pandemic since March 2020. We describe here, two cases of COVID-19 infection in a post-transplant setting. First one is a 59-year old renal transplant recipient; the second is a 51-year old allogeneic bone marrow transplant recipient. Both patients were on immunosuppressant therapy and had stable graft function before COVID-19 infection. After the diagnosis of COVID-19, immunosuppressive agents were discontinued and methylprednisolone with prophylactic antibiotics were initiated, however, the lung injury progressed. The T cells were extremely low in both patients after infection. Both patients died despite the maximal mechanical ventilatory support. Therefore, the prognosis of COVID-19 pneumonia following transplantation is not optimistic and remains guarded. Lower T cell count may be a surrogate for poor outcome.