Co-infection of COVID-19 with dengue fever and acute graft dysfunction in a kidney transplant recipient - A case report

Among coronavirus disease 2019 (COVID-19) pandemic, endemic infections also peak in India during this monsoon. Kidney transplant recipients are at higher risk of contracting infections with increased morbidity and mortality. Co-infection of COVID-19 with other infections is apprehended with more unfavorable outcome. We report a case of young renal allograft recipient with co-infection of COVID-19 and dengue fever presenting with acute graft dysfunction. Apart from supportive treatment and reduction in immunosuppressants, the patient was managed with dexamethasone, remdesivir, and heparin. The patient responded to the treatment and graft dysfunction improved on conservative management. This case emphasizes the need to consider endemic diseases also during workup of COVID-19 patients and shows that co-infections even with acute graft dysfunction can also have favorable prognosis. This case also points out the difficulties faced in managing immunosuppressants due to fear of acute graft rejection.