Abstract: SA-PO852
Post-COVID-19 Syndrome Neuropsychiatric Complications Leading to Medication Non-Compliance and Acute Rejection in a Kidney Transplant Patient
Session Information
- Transplantation: Clinical - Case Reports
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Shaikh, Taha M., Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, United States
- Barrantes Ramirez, Thelmo Fidel Ernesto, Renal Medical Associates, Albuquerque, New Mexico, United States
- Kuperman, Michael Benjamin, Arkana Labs, Little Rock, Arkansas, United States
Introduction
Depression, anxiety, and fatigue, which can all contribute to medication non-adherence, have been described with different frequencies in post-COVID syndrome patients.
Case Description
The patient is a 41-year-old male with a past medical history of hypertension, type 2 diabetes mellitus, and hypothyroidism. He also has a history of end stage renal disease (ESRD) requiring kidney transplantation on 12/24/2017. He initially developed ESRD due to congenital unilateral renal agenesis and hypertension. He presented to the ED on 02/18/22 complaining of fatigue, dizziness, nausea and at least one prior syncopal episode. On 02/22/22, a kidney biopsy was taken showing evidence of acute vascular rejection, acute t-cell mediated rejection and acute antibody mediated rejection.
The patient described increased fatigue and depressive symptoms following COVID hospitalization in November 2021, which he had not experienced before. After recovering from COVID in the hospital, he reported sleeping excessively, feeling exhausted throughout the day, decreased interest in activities, difficulty concentrating, and an overall decreased mood without suicidality. This combination of fatigue and depressive symptoms led to his medical non-compliance. He had no prior psychiatric history or issues with non-compliance.
Discussion
It is very likely that this patient is one of the first reported cases of post-COVID syndrome phenomena leading to serious downstream consequences such as kidney allograft failure. The goal of this case report is to increase awareness of post-COVID syndrome particularly in patients with chronic conditions that require strict medication regimens. By having adequate surveillance of these patients by both their primary care physicians as well as any specialists involved it is certainly possible to reduce the occurrence of serious downstream consequences. An example of this increased surveillance is prompt follow-up after COVID hospitalization for any patient with chronic health conditions. Another possible intervention is the use of questionnaires or surveys for post-COVID patients that can measure the effects of post-COVID syndrome, similar to how the PHQ-9 is utilized for MDD. Most importantly, it is crucial to provide knowledge of this phenomenon to patients and physicians alike.