Threatening drug‐drug interaction in a kidney transplant patient with coronavirus disease 2019 (COVID‐19)

Bartiromo, Marilú; Borchi, Beatrice; Botta, Annarita; Bagalà, Alfredo; Lugli, Gianmarco; Tilli, Marta; Cavallo, Annalisa; Xhaferi, Brunilda; Cutruzzulà, Roberta; Vaglio, Augusto; Bresci, S.; Larti, A.; Bartoloni, Alessandro; Cirami, Calogero

doi:10.1111/tid.13286

Cited by 64 publications

(63 citation statements)

References 11 publications

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“…14 So far, however, only a few cases of COVID-19 have been reported in KT patients. [3][4][5] The patient we discuss presented overall clinical characteristics similar to those reported in non-transplanted COVID-19 patients. 14 Respiratory data on admission to the ICU were similar to non-immunosuppressed patients.…”

Section: Discussionsupporting

confidence: 57%

Successful recovery from severe COVID‐19 pneumonia after kidney transplantation: The interplay between immunosuppression and novel therapy including tocilizumab

Lauterio¹,

Valsecchi

Santambrogio

et al. 2020

Transplant Infectious Dis

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Our understanding of COVID-19 epidemiology and its clinical presentation is growing fast, yet few reports of COVID-19 among transplanted recipients have been published so far. 1-8 The risk of immunocompromised patients developing atypical severe COVID-19 is still under debate. 9 The severity of clinical manifestations and lung injury histology would seem especially to implicate over activation of the T-cell immune response. 10 Long-term immunosuppression with calcineurin inhibitors (CNIs) is known to affect T-cell proliferation and maturation, with consequent anti-inflammatory effects. 11 However, the question of whether long-term immunosuppressive therapy could shorten or mitigate the clinical course of COVID-19 in transplanted patients still awaits a definitive answer. Reports on the clinical course of transplant recipients treated with tocilizumab are scarce, and currently, only a few cases have been reported. 12 We present a case of successful recovery from severe COVID-19 of a kidney-transplanted patient treated according to our local protocol.

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Section: Discussionsupporting

confidence: 57%

Successful recovery from severe COVID‐19 pneumonia after kidney transplantation: The interplay between immunosuppression and novel therapy including tocilizumab

Lauterio¹,

Valsecchi

Santambrogio

et al. 2020

Transplant Infectious Dis

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“…Although renal dysfunction as reflected by decreased eGFR or increased serum levels of creatinine was not considered in the published reports as a co-morbidity, it is important to recognize that renal dysfunction of kidney transplant recipients with COVID-19 ought to be recognized as such. Nevertheless, numerous reports that we reviewed showed that patients with a decreased eGFR plus other comorbidities 39 , 41 , 43 , 44 , 47 , 48 , 52 , 55 or increased serum levels of creatinine plus other comorbidities 36 , 38 , 40 , 42 , 46 , 53 , 54 still achieved a positive outcome. Interestingly, Sharma et al recently completed a retrospective study in which they compared the clinical outcomes of COVID-19 between solid organ transplant recipients and matched nontransplant patients in their medical center, and they found the need for renal replacement therapy in the organ recipients did not affect the incidence of severe COVID-19 and the rate of short-term death 70 .…”

Section: Discussionmentioning

confidence: 91%

Clinical Outcomes of COVID-19 Patients with Pre-existing, Compromised Immune Systems: A Review of Case Reports

Dayan¹,

Kersten²,

Battaglia³

et al. 2020

Int. J. Med. Sci.

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In the ongoing COVID-19 pandemic, all COVID-19 patients are naïve patients as it is the first-time humans have been exposed to the SARS-CoV-2 virus. As with exposure to many viruses, individuals with pre-existing, compromised immune systems may be at increased risk of developing severe symptoms and/or dying because of (SARS-CoV-2) infection. To learn more about such individuals, we conducted a search and review of published reports on the clinical characteristics and outcomes of COVID-19 patients with pre-existing, compromised immune systems. Here we present our review of patients who possess pre-existing primary antibody deficiency (PAD) and those who are organ transplant recipients on maintenance immunosuppressants. Our review indicates different clinical outcomes for the patients with pre-existing PAD, depending on the underlying causes. For organ transplant recipients, drug-induced immune suppression alone does not appear to enhance COVID-19 mortality risk - rather, advanced age, comorbidities, and the development of secondary complications appears required.

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“…Fourteen articles were included in the analysis of KT patients with COVID-19. Among these, six were case reports/case series (22)(23)(24)(25)(26)(27), five were correspondences (10,(28)(29)(30)(31), one was a guideline (32), one an editorial (33), and one was a case series on SOT (7). Twenty-three KT cases were described.…”

Section: Kidney Transplant Patientsmentioning

confidence: 99%

COVID-19 in solid organ transplantation patients: A systematic review

Nacif¹,

Zanini²,

Waisberg³

et al. 2020

Clinics

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Coronavirus disease (COVID-19) rapidly progresses to severe acute respiratory syndrome. This review aimed at collating available data on COVID-19 infection in solid organ transplantation (SOT) patients. We performed a systematic review of SOT patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MEDLINE and PubMed databases were electronically searched and updated until April 20, 2020. The MeSH terms used were ''COVID-19'' AND ''Transplant.'' Thirty-nine COVID-19 cases were reported among SOT patients. The median interval for developing SARS-CoV-2 infection was 4 years since transplantation, and the fatality rate was 25.64% (10/39). Sixteen cases were described in liver transplant (LT) patients, and the median interval since transplantation was 5 years. The fatality rate among LT patients was 37.5% (6/16), with death occurring more than 3 years after LT. The youngest patient who died was 59 years old; there were no deaths among children. Twenty-three cases were described in kidney transplant (KT) patients. The median interval since transplantation was 4 years, and the fatality rate was 17.4% (4/23). The youngest patient who died was 71 years old. Among all transplant patients, COVID-19 had the highest fatality rate in patients older than 60 years : LT, 62.5% vs 12.5% (p=0.006); KT 44.44% vs 0 (p=0.039); and SOT, 52.94% vs 4.54% (p=0.001). This study presents a novel description of COVID-19 in abdominal SOT recipients. Furthermore, we alert medical professionals to the higher fatality risk in patients older than 60 years. (PROSPERO, registration number= CRD42020181299)

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Threatening drug‐drug interaction in a kidney transplant patient with coronavirus disease 2019 (COVID‐19)

Cited by 64 publications

References 11 publications

Successful recovery from severe COVID‐19 pneumonia after kidney transplantation: The interplay between immunosuppression and novel therapy including tocilizumab

Successful recovery from severe COVID‐19 pneumonia after kidney transplantation: The interplay between immunosuppression and novel therapy including tocilizumab

Clinical Outcomes of COVID-19 Patients with Pre-existing, Compromised Immune Systems: A Review of Case Reports

COVID-19 in solid organ transplantation patients: A systematic review

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