PMID- 33431539
OWN - NLM
STAT- MEDLINE
DCOM- 20210118
LR  - 20231110
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 14
IP  - 1
DP  - 2021 Jan 11
TI  - Complete recovery from COVID-19 of a kidney-pancreas transplant recipient: 
      potential benefit from everolimus?
LID - 10.1136/bcr-2020-238413 [doi]
LID - e238413
AB  - We present a kidney-pancreas transplant recipient who achieved complete recovery 
      from COVID-19. A 45-year-old patient with T3 paraplegia underwent kidney-pancreas 
      transplantation 18 years ago, followed by a subsequent kidney transplant 9 years 
      ago, and presented with fever, hypoxia and hypotension after exposure to two 
      confirmed cases of COVID-19. History of solid organ transplant, pre-existing 
      renal impairment, asthma and an elevated D-dimer were identified as established 
      risk factors for severe COVID-19. Supportive management was provided, baseline 
      immunosuppression with everolimus was continued, and oral prednisolone was 
      increased. A complete recovery was observed. Given the favourable outcome despite 
      risk factors for severe COVID-19, we identify and review the potential mitigating 
      roles of immunosuppression and mammalian target of rapamycin (mTOR) inhibitors in 
      this disease. Further investigation is required to establish whether mTOR 
      inhibitors could be used as therapeutic agents to treat COVID-19, or as 
      alternative immunosuppression implemented early in the COVID-19 disease course.
CI  - (c) BMJ Publishing Group Limited 2020. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Heron, Vanessa C
AU  - Heron VC
AUID- ORCID: 0000-0002-7659-6264
AD  - Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia.
FAU - Bach, Cindy-Anne T
AU  - Bach CT
AD  - Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia.
FAU - Holmes, Natasha E
AU  - Holmes NE
AUID- ORCID: 0000-0001-8501-4054
AD  - Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
FAU - Whitlam, John B
AU  - Whitlam JB
AUID- ORCID: 0000-0003-2202-1462
AD  - Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia 
      john.whitlam@austin.org.au.
AD  - Department of Medicine, Austin Health, Heidelberg, Victoria, Australia.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210111
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (fibrin fragment D)
RN  - 9HW64Q8G6G (Everolimus)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Accidents, Traffic
MH  - Asthma/complications
MH  - COVID-19/*complications/metabolism/physiopathology/therapy
MH  - Diabetes Mellitus, Type 1/complications/surgery
MH  - Everolimus/therapeutic use
MH  - Fever/physiopathology
MH  - Fibrin Fibrinogen Degradation Products/metabolism
MH  - Glucocorticoids/*therapeutic use
MH  - Graft Rejection/*prevention & control
MH  - Humans
MH  - Hypotension/physiopathology
MH  - Hypoxia/physiopathology
MH  - Immunosuppressive Agents/*therapeutic use
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - *Pancreas Transplantation
MH  - Paraplegia/*complications
MH  - Prednisolone/therapeutic use
MH  - SARS-CoV-2
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
PMC - PMC7802699
OTO - NOTNLM
OT  - drugs: infectious diseases
OT  - renal transplantation
COIS- Competing interests: None declared.
EDAT- 2021/01/13 06:00
MHDA- 2021/01/20 06:00
PMCR- 2021/01/11
CRDT- 2021/01/12 05:50
PHST- 2021/01/12 05:50 [entrez]
PHST- 2021/01/13 06:00 [pubmed]
PHST- 2021/01/20 06:00 [medline]
PHST- 2021/01/11 00:00 [pmc-release]
AID - 14/1/e238413 [pii]
AID - bcr-2020-238413 [pii]
AID - 10.1136/bcr-2020-238413 [doi]
PST - epublish
SO  - BMJ Case Rep. 2021 Jan 11;14(1):e238413. doi: 10.1136/bcr-2020-238413.