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Abstract: FR-PO036

Successful Outcome of AKI in a Patient With Leptospirosis and COVID-19 Infection

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Tchokhonelidze, Irma, Tbilsi State medical University, Tbilisi, Please Select, Georgia
  • Tevdoradze, Tamar, Tbilsi State medical University, Tbilisi, Please Select, Georgia

Group or Team Name

  • Tbilisi State Medical University Clinic
Introduction

Severe leptospirosis manifests as pulmonary edema leading to ARDS. Superimposed Covid-19 increases the risk ARDS and AKI. Cytokine storm is the main incriminating factor in both. High-dose steroids have been used to facilitate the effects of covid-19 and leptospirosis.

Case Description

A 31-year-old male farmer was admitted to ER on Nov 10, 2020. According to PMH, the diseases presented on Nov 3 with chills, fever, abdominal pain, diarrhea. On admission he had decreased urine output, edema, fever, abdominal pain, diarrhea. Laboratory tests were significant for uremia, abnormal liver enzymes, thrombocytopenia, leukocytosis, elevated LDH. Leptospirosis serology test was positive. Doxycycline 200mg added. Hemodialysis was started. Oxygen saturation fell to 74% on room air. Nasopharyngeal swab tested positive for COVID-19. Methylprednisolone 500mg i/v for three consecutive days, followed by 32mg. Chest CT showed bilateral ground-glass opacities Fig.1.
From Nov 23 his clinical condition improved: urine output increased, oxygen saturation became 98% on room air, bowel movements one time per day. He was discharged. In December serum creatinine dropped to basic levels ( 89 mcmol/L). CT scan of the lungs showed almost complete resolution of the opacities Fig.2.

Discussion

Our case demonstrates successful resolution of the severe ARDS, AKI, with complete restoration of the kidney function under steroid therapy. Further trials are needed to elaborate recommendations on steroid therapy during co-existing covid-19 and leptospirosis.