Grand Journal of Urology
E-ISSN : 2757-7163

COVID-19
Original Article
Grand J Urol 2021;1(3):109-115, DOI: 10.5222/GJU.2021.75047
Objective: To investigate whether tacrolimus (Tac), mycophenolate mofetil (MMF), mycophenolic acid (MPA), prednisolone (Pred) and methylprednisolone (MP) are affect the COVID-19 pathogenesis and on its progression in kidney transplantation recipients diagnosed with COVID-19 patients. Materials and Methods: Among patients hospitalized due to COVID-19, patients who had kidney transplantation were retrospectively detected on the online database of our center. Referral complaints, laboratory and radiological data at referral, applied treatment protocols, and ultimate conditions of the patients were documented. Results: Among the total of 11 patients, 73% (8) were male and 27% (3) were female. The mean age was 49.63 (27-71). Hypertension and diabetes mellitus were the most common comorbid diseases. The most common symptoms were coughing, fever and exhaustion-fatigue. High serum reactive protein and lymphopenia were detected in almost all patients. Acute renal failure was observed in seven patients (73%). While all patients were using Tac and Pred, nine patients (82%) were using MMF and two patients (18%) were using MPA. Hydroxychloroquine, favipiravir, and azithromycin were treatments for COVID-19. RT-PCR results of 11 patients were positive in 7 and negative in 4 patients. The mean hospital stay of the discharged patients was 8.8 days. Eight patients recovered and were discharged, treatment of two intubated patients continues in intensive care unit and one patient died. Conclusion: Clinical characteristics of COVID-19 in kidney transplanted patients are similar to the general population and it should be kept in mind that the disease occurs with moderate-severe pneumonia in this patient group. Disease progress can be stopped through early treatment.
Case Report
Grand J Urol 2021;1(3):146-149, DOI: 10.5222/GJU.2021.79188
One of the reasons for the high mortality in COVID-19 patients is the increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism. For this reason, the use of anticoagulant treatments has become widespread. One of the rare complications of anticoagulant therapy is retroperitoneal hemorrhage. These hemorrhagies require immediate intervention. Retroperitoneal hemorrhage should be kept in mind among the many complications that develop in the patient who was followed up during the pandemic period. For this purpose, we present 2 cases who developed spontaneous retroperitoneal bleeding while clinically recovering under COVID-19 treatment.
COVID-19 is a highly contagious disease. This condition affects the decision of both the patient and the surgeon about the surgery of newly diagnosed cancer patients and it may also result in delays in cancer surgeries because of the limitations in healthcare applications. In our particular case, it was aimed to present the transition of the cancer from the localized stage to distant spread stage cancer since the patient who was pre-diagnosed with RCC and who was recommended surgery, did not want to undergo surgery due to COVID-19 pandemic and its risks. Our case was a 49-year-old female patient. In her computed tomography, a 58x70 mm heterogeneously enhancing solid lesion which showed exophytic extension from the middle zone of the right kidney to the lower pole was observed. Surgery was recommended for the patient but the patient claimed that she did not want to undergo surgery due to the risk of COVID-19 pandemic. The patient made an application for the surgery 8 months later. The new magnetic resonance imaging of the patient showed that there was a mass lesion of approximately 76x76x80 mm in size, which involved middle-lower part of the right kidney and extended into the opening of the renal vein VCI by invading the renal vein. Radical nephrectomy and thrombectomy procedure was applied to the patient with RCC? tumor. Due to psychosocial problems caused by the pandemic, surgeries are delayed and an acceleration of the cancer progression from the localized stage to the distant spread stage occurs indispensably.