ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0828

Does Cyclophosphamide Exposure in Patients with Vasculitides Lead to Better COVID-19 Outcomes?

Session Information

Category: Trainee Case Report

  • 000 Coronavirus (COVID-19)

Authors

  • Zabiullah, Syed mohammed faizaan M., Metropolitan Hospital Center, New York, New York, United States
  • Gunarso, Arie, Metropolitan Hospital Center, New York, New York, United States
  • Chaudhari, Ashok P., Metropolitan Hospital Center, New York, New York, United States
Introduction

COVID 19 is a pandemic disease caused by novel coronavirus called SARS-CoV- 2. End Stage Renal Disease patients are at high risk for developing severe manifestations of the disease often associated with high morbidity and mortality.Excessive and uncontrolled immune response is thought to be one of the important underlying mechanism for severity of the disease. We present 3 ESRD patients with underlying vasculitides who were admitted with respiratory distress due to COVID 19.

Case Description

All 3 patients presented with shortness of breath and had typical features of COVID 19 including hypoxia, fever; extensive bilateral interstitial infiltrates on Chest X rays, lymphocytopenia, elevated LDH; and ferritin.
The first patient is a 37-year-old Hispanic male with ANCA -PR3 related vasculitis resulting in ESRD, on hemodialysis. He had been treated with Cyclophosphamide and prednisone induction therapy and is on maintenance prednisone.
The second patient is a 40-year-old male with ESRD secondary to crescentic IgA nephropathy. He had been treated with cyclophosphamide and prednisone induction.
The third patient is a 43-year-old female with SLE; ESRD secondary to lupus nephritis. She had been treated with cyclophosphamide and prednisone induction and is on maintenance prednisone.
All 3 patients recovered in the hospital with oxygen supplementation and did not require NIV or intubation.

Discussion

We hypothesize that due to residual immunosuppressive action of cyclophosphamide, the inflammatory response in these patients was probably blunted. And this could have led to better outcome in these patients. Due to lots of unknowns related to COVID 19, further prospective/retrospective studies should be done looking at outcomes of COVID 19 in patients who had received cyclophosmide previously.