Favipiravir in Kidney Transplant Recipients With COVID-19: A Romanian Case Series
| Autor: | Cristina Cismaru, Alina Daciana Elec, Adriana Muntean, Tudor Moisoiu, Mihaela Lupșe, Oana Antal, Florin Ioan Elec |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
KTx kidney transplant KDIGO Kidney Disease Improving Global Outcomes Antiviral Agents Article FPV Favipiravir antivirals Humans CKD-EPI Chronic Kidney Disease Epidemiology Collaboration Transaminases COVID-19 coronavirus disease 2019 Retrospective Studies SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 CCI Charlson comorbidity index Romania SARS-CoV-2 Middle Aged RNA-Dependent RNA Polymerase ICU intensive care unit Amides Kidney Transplantation Transplant Recipients COVID-19 Drug Treatment Oxygen Treatment Outcome Creatinine Pyrazines outcome adverse effects Surgery disease severity Female MMF mycophenolate mofetil ERA-EDTA European renal Association- European Dialysis and Transplantation Association transplantation |
| Zdroj: | Transplantation Proceedings |
| ISSN: | 1873-2623 |
| Popis: | Background: Favipiravir (FPV) is an orally administrable antiviral drug which selectively inhibits RNA-dependent RNA polymerase and which has been repurposed for COVID-19 treatment. There is limited information on the use of FPV in kidney transplant recipients (KTx), who often have multiple comorbidities and run a higher risk for death from COVID-19. Methods: We retrospectively reviewed all KTx at our institution who got sick with COVID-19 between March 1st, 2020 and May 31st, 2021 and who received FPV (loading dose of 1800 mg x 2 on Day 1, maintenance dose 2 x 800 mg/d for 5-14 days) as part of their COVID-treatment. We analyzed demographics, clinical course, laboratory data, management and outcome. Results: Nine KTx recipients with COVID-19 received FPV, all were hospitalized. The median age was 52 (range 32–60) and women were predominant (77,7%). Eight KTx had pulmonary involvement on the chest x-ray. Upon admission one patient had mild, five had moderate, two had severe and one had critical disease. Leukopenia and increased creatinine were universally noted. Three patients had disease progression under treatment. Seven patients (77,7%) required additional oxygen and four (57,1%) needed ICU admission. Three KTx died, resulting in an overall mortality of 33,3%. Survivors did not show increased transaminases and creatinine during or after FPV treatment; leukocytes, neutrophils and platelets improved upon discharge compared with admission values. Discussion: FPV appears well tolerated by KTx with COVID-19 but its clinical benefit remains unclear. Larger analyses are needed. |
| Databáze: | OpenAIRE |
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