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A 45-year-old patient with T3 paraplegia underwent kidney-pancreas transplantation 18 years ago, followed by a subsequent kidney transplant 9 years ago, and presented with fever, hypoxia and hypotension after exposure to two confirmed cases of COVID-19. History of solid organ transplant, pre-existing renal impairment, asthma and an elevated D-dimer were identified as established risk factors for severe COVID-19. Supportive management was provided, baseline immunosuppression with everolimus was continued, and oral prednisolone was increased. A complete recovery was observed. Given the favourable outcome despite risk factors for severe COVID-19, we identify and review the potential mitigating roles of immunosuppression and mammalian target of rapamycin (mTOR) inhibitors in this disease. Further investigation is required to establish whether mTOR inhibitors could be used as therapeutic agents to treat COVID-19, or as alternative immunosuppression implemented early in the COVID-19 disease course.<\/jats:p>","DOI":"10.1136\/bcr-2020-238413","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T14:21:52Z","timestamp":1610461312000},"page":"e238413","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Complete recovery from COVID-19 of a kidney-pancreas transplant recipient: potential benefit from everolimus?"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7659-6264","authenticated-orcid":false,"given":"Vanessa C","family":"Heron","sequence":"first","affiliation":[{"name":"Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy-Anne T","family":"Bach","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8501-4054","authenticated-orcid":false,"given":"Natasha E","family":"Holmes","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2202-1462","authenticated-orcid":false,"given":"John B","family":"Whitlam","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia"},{"name":"Department of Medicine, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2025082803512410000_14.1.e238413.1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/jmv.25722","article-title":"Understanding of COVID\u201019 based on current evidence","volume":"92","author":"Sun","year":"2020","journal-title":"J Med Virol"},{"doi-asserted-by":"crossref","unstructured":"Li F , Cai J , Dong N . 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