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Managing COVID-19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid-sparing Immunosuppression.
Pharmacotherapy. 2020 Apr 27;:
Authors: Johnson KM, Belfer JJ, Peterson GR, Boelkins MR, Dumkow LE
Abstract
Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome virus (SARS-CoV-2) has become a global healthcare crisis. The Centers for Disease Control and Prevention (CDC) lists immunocompromised patients, including those requiring immunosuppression following renal transplantation, as high-risk for severe disease from SARS-CoV-2. Treatment for other viral infections in renal transplant recipients often includes a reduction in immunosuppression, however, there are no current guidelines recommending the optimal approach to managing immunosuppression in the patients who are infected with SARS-CoV-2. It is currently recommended to avoid corticosteroids in the treatment of SARS-CoV-2 outside of critically ill patients. Recently published cases describing the inpatient care of COVID-19 in renal transplant recipients differ widely in disease severity, time from transplantation, baseline immunosuppressive therapy, and the modifications made to immunosuppression during COVID-19 treatment. The purpose of this review is to summarize and compare inpatient immunosuppressant management strategies of recently published reports in the renal transplant population infected with SARS-CoV-2 and to discuss the limitations of corticosteroids in managing immunosuppression in this patient population.
PMID: 32339304 [PubMed - as supplied by publisher]