Fatal breakthrough infection in a kidney transplant recipient

A 76-y-old male individual with end-stage kidney disease secondary to IgA nephropathy who underwent kidney transplantation with antithymocyte globulin induction 6 y prior presented with exertional dyspnea. His physical examination suggested that he did not need a close medical attention and chest X-ray did not demonstrate any acute findings. He was discharged with a 6-d course of glucocorticoid therapy. When he presented again, Chest X-ray showed an interstitial opacity in the left lower lung. His SARS-CoV-2 PCR test was positive but antibody was not detectable. Despite all efforts, he continued to decompensate and died on the seventh day after admission.

He completed a 2-dose series of COVID-19 vaccine (mRNA-1273, Moderna; Cambridge, MA) at the recommended 4-wk interval and received the second dose in mid-February 


Case Report: Severe COVID-19 in a Kidney Transplant Recipient Without Humoral Response to SARS-CoV-2 mRNA Vaccine Series

Masaaki Yamada, MD,corresponding author1,2 Eiyu Matsumoto, MB,1,3 Christie P. Thomas, MBBS,1,2 Jennifer R. Carlson, PA-C,3 J. Stacey Klutts, MD, PhD,4,5 Bharat Kumar, MD,1,2 Judy A. Streit, MD,1,2 and Melissa L. Swee, MD1,2
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corresponding authorCorresponding author.
Correspondence: Masaaki Yamada, MD, Division of Nephrology, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242. (ude.awoiu@adamay-ikaasam).

 Case Report: Severe COVID-19 in a Kidney Transplant Recipient Without Humoral Response to SARS-CoV-2 mRNA Vaccine Series (nih.gov)

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