Calcineurin inhibitors revisited: A new paradigm for COVID-19?

Hage, René; Steinack, Carolin; Schuurmans, Macé M.

doi:10.1016/j.bjid.2020.06.005

Cited by 24 publications

(22 citation statements)

References 5 publications

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“…Based on what we discussed above, several studies have recommended evaluating the efficacy of calcineurin inhibitors in preventing and treating COVID-19 [16] , [17] . However, in our study, no therapeutic effect was observed when ciclosporin was administered to treat COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial

Barati

Hashemian

Tabarsi

et al. 2021

International Immunopharmacology

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Background Regarding the COVID-19 pandemic, potential therapeutic agents are being evaluated almost every day. Ciclosporin, a calcineurin inhibitor, is characterized by beneficial antiviral and immunomodulatory effects. The present study aimed to evaluate the efficacy of ciclosporin in managing COVID-19. Methods This study was a prospective non-controlled clinical trial carried out on 20 patients. Confirmed COVID-19 patients received two doses of ciclosporin (10 mg/kg and 5 mg/kg injections) 24 hours apart. Mortality rate and the lengths of intensive care unit (ICU) and hospital stays were assessed for all 20 patients. Results The mortality rate and the need for mechanical ventilation were calculated as 50%. The percentage of ICU admission was 70%. The lengths of ICU and hospital stays were 8.13 ± 6.81 and 14.25 ± 8.55 days, respectively. The levels of ferritin and white blood cells were significantly higher after injecting the second dose of ciclosporin. Seven patients (35%) had radiologically improved lungs after ciclosporin therapy. Conclusion It seems that the protocol of two doses of ciclosporin in combination with favipiravir does not have favorable effects among COVID-19 patients that do not respond to dexamethasone. Controlled trials are needed to confirm the results.

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Section: Discussionmentioning

confidence: 99%

Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial

Barati

Hashemian

Tabarsi

et al. 2021

International Immunopharmacology

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“…CNIs may also have a role in ameliorating COVID-19 induced cytokine storm. CNIs inhibit T-cell activation and suppress cytokines (interleukin (IL)-2, IL-4, tumor necrosis factor-a and interferon-c) that mediate the cytokine storm [21]. The available data are not strong enough to advocate the use of CNIs as a treatment for COVID-19 infection.…”

Section: Calcineurin Inhibitors (Cnis)mentioning

confidence: 99%

Immunosuppression in kidney transplant recipients with COVID-19 infection – where do we stand and where are we heading?

et al. 2021

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The appropriate immunosuppressive regimen in kidney transplant recipients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2/COVID-19) infection remains unclear. The impact of direct virus injury complicated by dysregulated hyperimmune response with overwhelming release of various cytokines in COVID-19 infected subjects contributes to the complexity of management. The largest concern of the practicing clinicians at current time is how to tailor maintenance immune-modulating therapy during active viral infection and the efficacy of the soon-to-be upcoming immunization for COVID-19. This targeted review aims to cover most of the current evidence on the effect of key maintenance immunosuppressive agents in COVID-19 infection and proposes a line of management to specific scenarios on this very rapidly evolving subject.

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“…Calcineurin inhibitors (CNIs) may also have a role in reducing COVID-19 induced cytokine storm. CNIs inhibit T-cell activation and suppress cytokines (IL-2, IL-4, TNF-α, and IFN-γ) that mediate the cytokine storm[ 79 ]. A multivariate analysis of 243 LT patients from 36 different facilities found that tacrolimus is associated with lower mortality of COVID 19 infection than other immunosuppressants such as cyclosporin mycophenolate mofetil and mTOR inhibitors[ 80 ].…”

Section: Current Immunosuppression Regimen and Implications On Pharmacotherapymentioning

confidence: 99%

Liver transplantation during global COVID-19 pandemic

Alfishawy¹,

Nso²,

Nassar³

et al. 2021

WJCC

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The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory disease respiratory syndrome coronavirus-2 has significantly impacted the health care systems globally. Liver transplantation (LT) has faced an unequivocal challenge during this unprecedented time. This targeted review aims to cover most of the clinical issues, challenges and concerns about LT during the COVID-19 pandemic and discuss the most updated literature on this rapidly emerging subject.

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Calcineurin inhibitors revisited: A new paradigm for COVID-19?

Cited by 24 publications

References 5 publications

Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial

Combined Therapy of Ciclosporin Plus Favipiravir in the Management of Patients with Severe COVID-19, not Responding to Dexamethasone: A non-Controlled Prospective Trial

Immunosuppression in kidney transplant recipients with COVID-19 infection – where do we stand and where are we heading?

Liver transplantation during global COVID-19 pandemic

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