Convalescent plasma therapy and remdesivir duo successfully salvaged an early liver transplant recipient with severe COVID-19 pneumonia

Jamir, Imtiakum; Lohia, Pankaj; Pande, Rajesh; Setia, Rasika; Singhal, Amit; Chaudhary, Abhideep

doi:10.14701/ahbps.2020.24.4.526

Cited by 11 publications

(10 citation statements)

References 18 publications

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“… 43 Successful disease management with remdesivir was also reported in liver transplants patients as the bilirubin and aminotransferase levels did not elevate during the period, or such elevation was insignificant. 44 , 52 A case of remdesivir initiation immediately post‐liver transplant showed near‐complete recovery after 3 months, but it is unclear if remdesivir directly caused the elevated liver enzymes following the transplant. 53 The patient had increased CT value only when the remdesivir was initiated and had negative PCR result within a month.…”

Section: Discussionmentioning

confidence: 99%

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Wong

Cheng

et al. 2022

Aliment Pharmacol Ther

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Aim To investigate and quantify the risks of AKI and ALI associated with remdesivir use, given the underlying diseases of SARS‐CoV‐2 infection. Methods This self‐controlled case series (SCCS) study was conducted using electronic hospital records between 23 January 2020 and 31 January 2021 as retrieved from the Hong Kong Hospital Authority which manages all laboratory‐confirmed COVID‐19 cases in Hong Kong. Outcomes of AKI and ALI were defined using the KDIGO Guideline and Asia Pacific Association of Study of Liver consensus guidelines. Incidence rate ratios (IRR) for AKI and ALI following the administration of remdesivir (exposure) in comparison to a non‐exposure period were estimated using the conditional Poisson regression models. Results Of 860 COVID‐19 patients administered remdesivir during hospitalisation, 334 (38.8%) and 137 (15.9%) had incident ALI and AKI, respectively. Compared with the baseline period, both ALI and AKI risks were increased significantly during the pre‐exposure period (ALI: IRR = 6.169, 95% CI = 4.549–8.365; AKI: IRR = 7.074, 95% CI = 3.763–13.298) and remained elevated during remdesivir treatment. Compared to the pre‐exposure period, risks of ALI and AKI were not significantly higher in the first 2 days of remdesivir initiation (ALI: IRR = 1.261, 95% CI = 0.915–1.737; AKI: IRR = 1.261, 95% CI = 0.889–1.789) and between days 2 and 5 of remdesivir treatment (ALI: IRR = 1.087, 95% CI = 0.793–1.489; AKI: IRR = 1.152, 95% CI = 0.821–1.616). Conclusion The increased risks of AKI and ALI associated with intravenous remdesivir treatment for COVID‐19 may be due to the underlying SARS‐CoV‐2 infection. The risks of AKI and ALI were elevated in the pre‐exposure period, yet no such increased risks were observed following remdesivir initiation when compared to the pre‐exposure period.

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Section: Discussionmentioning

confidence: 99%

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Wong

Cheng

et al. 2022

Aliment Pharmacol Ther

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“…The successful management of severe COVID-19 pneumonia was reported in liver transplant recipients early after transplantation and treatment with remdesivir and convalescent plasma [ 81 ]. Another liver transplant recipient who suffered from COVID-19 with encephalopathy was successfully treated with remdesivir and convalescent plasma [ 82 ].…”

Section: Therapeutic Options In Sot Recipients In Covid-19mentioning

confidence: 99%

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Dęborska−Materkowska

Kamińska

2021

Viruses

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Since its outbreak in December 2019, the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an enormous rise in scientific response with an excess of COVID-19-related studies on the pathogenesis and potential therapeutic approaches. Solid organ transplant (SOT) recipients are a heterogeneous population with long-lasting immunosuppression as a joining element. Immunocompromised patients are a vulnerable population with a high risk of severe infections and an increased infection-related mortality rate. It was postulated that the hyperinflammatory state due to cytokine release syndrome during severe COVID-19 could be alleviated by immunosuppressive therapy in SOT patients. On the other hand, it was previously established that T cell-mediated immunity, which is significantly weakened in SOT recipients, is the main component of antiviral immune responses. In this paper, we present the current state of science on COVID-19 immunology in relation to solid organ transplantation with prospective therapeutic and vaccination strategies in this population.

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“…Recipients of solid organ transplants are known to be vulnerable to viral infections secondary to a weakened T‐cell mediated immune response 86 . From 10 case reports 87–96 and 10 case series, 25,97–105 we identified 66 COVID‐19 patients who received a solid organ transplant and who were treated with convalescent plasma. Of these 66 patients, mortality was observed in nine patients (14%), 4 patients remain hospitalized at the end of the observation period, and 25 patients demonstrated rapid improvement in clinical symptomatology.…”

Section: Secondary Immunodeficiencymentioning

confidence: 99%

Use of convalescent plasma inCOVID‐19 patients with immunosuppression

et al. 2021

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In the absence of effective countermeasures, human convalescent plasma has been widely used to treat severe acute respiratory syndrome coronavirus 2, the causative agent of novel coronavirus disease 19 (COVID‐19), including among patients with innate or acquired immunosuppression. However, the association between COVID‐19‐associated mortality in patients with immunosuppression and therapeutic use of convalescent plasma is unknown. We review 75 reports, including one large matched‐control registry study of 143 COVID‐19 patients with hematological malignancies, and 51 case reports and 23 case series representing 238 COVID‐19 patients with immunosuppression. We review clinical features and treatment protocols of COVID‐19 patients with immunosuppression after treatment with human convalescent plasma. We also discuss the time course and clinical features of recovery. The available data from case reports and case series provide evidence suggesting a mortality benefit and rapid clinical improvement in patients with several forms of immunosuppression following COVID‐19 convalescent plasma transfusion. The utility of convalescent plasma or other forms of antibody therapy in immune‐deficient and immune‐suppressed patients with COVID‐19 warrants further investigation.

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Convalescent plasma therapy and remdesivir duo successfully salvaged an early liver transplant recipient with severe COVID-19 pneumonia

Cited by 11 publications

References 18 publications

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

The Immunology of SARS-CoV-2 Infection and Vaccines in Solid Organ Transplant Recipients

Use of convalescent plasma inCOVID‐19 patients with immunosuppression

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