Telemedicine in the Care of Kidney Transplant Recipients With Coronavirus Disease 2019: Case Reports

Kidney transplant recipients who develop symptoms consistent with COVID-19 are bringing unique challenges to health care professionals. Telemedicine has surged dramatically since the pandemic in efforts to maintain patient care and reduce the risk of COVID-19 exposure to patients, healthcare workers, and the public. Herein we present reports of three kidney transplant recipients with COVID-19 that were managed using telemedicine via synchronous video visits integrated with an electronic medical records system, from home to inpatient settings. We demonstrate how telemedicine helped assess, diagnose, triage, and treat patients with COVID-19 while avoiding an emergency room or outpatient clinic visit. While there is limited information about the duration of viral shedding for immunosuppressed patients, our findings underscore the importance of using telemedicine in the follow-up care for kidney transplant recipients with COVID-19 who have recovered from symptoms but might have persistently positive NAT tests. Our experience emphasizes the opportunities of telemedicine in the management of kidney transplant recipients with COVID-19 and in the maintenance of uninterrupted follow-up care for such immunosuppressed patients with prolonged viral shedding. Telemedicine may help increase access to care for kidney transplant recipients during and beyond the pandemic as it offers a prompt, safe, and convenient platform in the delivery of care for these patients. Yet in order to advance the practice of telemedicine in the field of kidney transplantation, barriers to increasing the widespread implementation of telemedicine should be removed, and research studies to assess the effectiveness of telemedicine in the care kidney transplant recipients are needed.
Highlights • Telemedicine helped diagnose, triage, and manage transplant patients with COVID-19 • Practical workflow process for COVID-19 test and surveillance • Telemedicine aid from home to inpatient settings, while avoiding ER or clinic visit • Telemedicine provides prompt, safe, and convenient approach to COVID-19 patients • Care delivery for immunosuppressed patients with prolonged COVID-19 shedding • Uninterrupted follow-up care for kidney transplant recipients with COVID-19