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Case report
Persistent viral shedding despite seroconversion in a kidney transplant recipient with severe extrapulmonary COVID-19
  1. Jack Italiano1,
  2. Rachel Bush1,
  3. Ratna Acharya2 and
  4. Kiran Upadhyay1
  1. 1Pediatric Nephrology, University of Florida Health, Gainesville, Florida, USA
  2. 2Pediatrics, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Kiran Upadhyay; dockiranbp{at}yahoo.com

Abstract

Renal transplant (RT) recipients are at increased risk for infectious complications. The clinical course of COVID-19 has been described in several RT recipients with varying clinical outcomes. Most present with pulmonary manifestations, however extrapulmonary presentations are not uncommon. Also, the timing and efficacy of seroconversion in transplant recipients is not well known. This report describes the duration of viral shedding and timing of seroconversion in a young adult RT recipient with COVID-19 who presented with severe diarrhoea and acute kidney injury requiring dialysis. She developed anti‐SARS‐CoV‐2 IgG antibody after 5 weeks despite persistently shedding the virus in the nasopharynx until 6 weeks after symptom onset. Further studies are needed to determine if immunosuppressed patients have prolonged viral shedding and are still contagious despite seroconversion.

  • infections
  • renal medicine
  • dialysis
  • renal transplantation

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-239612

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    Footnotes

    • Contributors JI, RB, RA and KU collected data, drafted the initial manuscript and reviewed and revised the manuscript. KU collected data, conceptualised the study, drafted the initial manuscript and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.