Comparison of the Different Medications for COVID-19 in Kidney Transplant Recipients
Yingxin Fu, Jianyong Pan, Weijun Chen, Yitao Zheng, Zixuan Wu, Yongdong Liu, Yuanzheng Peng, Hongzhou Lu
doi:10.22541/au.168777909.90198442/v1
Background We analyzed the effects of small-molecule antiviral treatment for coronavirus disease-2019 (COVID-19) Omicron strain in kidney transplant recipients. Methods We enrolled 140 kidney transplant patients admitted for COVID-19-related pneumonia were treated using small-molecule antivirals. Patients were divided into three groups: azvudine (n=62), paxlovid (n=49), and a combination of azvudine+paxlovid (A+P, n=29). Differences in clinical outcomes owing to COVID-19 infections were compared among three groups. Results Paxlovid group had a higher proportion of comorbid diabetes than the other two groups (P=0.032). There were differences in the clinical typing of the coronavirus , with the highest proportion of heavy and critical cases in the A+P group (35.5%). The immunosuppression prior to infection did not differ among the groups; however, after adjusting for immunosuppression during antiviral treatment, differences were observed. Of the 140 patients, 125 (89.29%) had fever, 114 (81.43%) had cough, and 66 (47.1%) had malaise. Combination of two or more symptoms were found in 90% patients. Mean length of hospitalization was slightly longer in the combination group than in the azvudine and paxlovid groups. Four deaths, all in the A+P group; five cases of loss of function, two in the paxlovid group and three in the A+P group; and acute kidney injury occurred in 30 patients with 7 in the azvudine, 17 in paxlovid, and 6 in A+P groups. Conclusion The use of small-molecule medications may be the optimal treatment approach; however, they should be modified based on the patients' conditions, such as clinical symptoms, laboratory results, paraclinicals, and examinations.
CONCLUSION The use of small-molecule medications may be the optimal treatment approach; however, they should be modified based on the patients' conditions, such as clinical symptoms, laboratory results, paraclinicals, and examinations.
References
References
Akalin, Azzi, Bartash, Covid-19 and kidney transplantation[J], N Engl J Med
Ao, Wang, Qi, The association between severe or death COVID-19 and solid organ transplantation: a systematic review and meta-analysis, Transplant Rev (Orlando)
Baig, Khaleeq, Ali, Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms [J], ACS Chemical Neuroscience
Beigel, Tomashek, Dodd, Remdesivir for the treatment of Covid-19-final report, N Engl J Med
Bernal, Da Silva, Musungaie, Molnupiravir for oral treatment of covid-19 in nonhospitalized patients, N Engl J Med
Callaway, Heavily mutated Omicron variant puts scientists on alert [J], Nature
Chaplin, Paxlovid: antiviral combination for the treatment of COVID-19, Prescriber
Chen, Shi, Dong, SARS-CoV-2 Lambda variant: spatiotemporal distribution and potential, Zoonoses
Chen, Zhou, Dong, Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, J]. Lancet
Farouk, Fiaccadori, Cravedi, COVID-19 and the kidney: what we think we know so far and what we don't [J], J Nephrol
Gottlieb, Vaca, Paredes, Early remdesivir to prevent progression to severe covid-19 in outpatients, N Engl J Med
Hammitt, Dagan, Yuan, Nirsevimab for prevention of RSV in healthy late-preterm and term infants [J], New Engl J Med
Hammond, Leister-Tebbe, Gardner, Oral nirmatrelvir for highrisk, nonhospitalized adults with covid-19, N Engl J Med
Hirose R, Itoh, Differences in environmental stability among SARS-CoV-2 variants of concern: both omicron BA.1and BA.2 have higher stability, J]. Clin Microbiol Infect
Hui, Zumla, Severe acute respiratory syndrome historical, epidemiologic, and clinical features, Infect Dis Clin N Am
Loo, Mctamney, Arends R H, The SARS-CoV-2 monoclonal antibody combination, AZD7442, is protective in nonhuman primates and has an extended half-life in humans [J], Science translational medicine
Piechotta, Iannizzi, Chai, Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review, Cochrane Database Syst Rev
Plante, Liu, Liu, Author Correction: Spike mutation D614G alters SARS-CoV-2 fitness [J], Nature
Pulliam, Van Schalkwyk, Govender, Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa, Science
Van Doremalen N, Bushmaker, Dh, Aerosol and surface stability of SARS-Cov-2 as compared with SARS-CoV-1 [J], N Engl J Med
Yokota, Miyamae, Imagawa, Therapeutic efficacy of humanized recombinant anti-interleukin-6 receptor antibody in children with systemic-onset juvenile idiopathic arthritis, Arthritis & Rheumatism
Zhang, Wang, Guo, Treatment of CD20-directed Chimeric Antigen Receptor-modified T cells in patients with relapsed or refractory B-cell non-Hodgkin lymphoma: an early phase IIa trial report, Signal Transduction & Targeted Therapy
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'abstract': '<jats:p id="p1">Background We analyzed the effects of small-molecule antiviral treatment\n'
'for coronavirus disease-2019 (COVID-19) Omicron strain in kidney\n'
'transplant recipients. Methods We enrolled 140 kidney transplant\n'
'patients admitted for COVID-19-related pneumonia were treated using\n'
'small-molecule antivirals. Patients were divided into three groups:\n'
'azvudine (n=62), paxlovid (n=49), and a combination of azvudine+paxlovid\n'
'(A+P, n=29). Differences in clinical outcomes owing to COVID-19\n'
'infections were compared among three groups. Results Paxlovid group had\n'
'a higher proportion of comorbid diabetes than the other two groups\n'
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'coronavirus , with the highest proportion of heavy and critical cases in\n'
'the A+P group (35.5%). The immunosuppression prior to infection did not\n'
'differ among the groups; however, after adjusting for immunosuppression\n'
'during antiviral treatment, differences were observed. Of the 140\n'
'patients, 125 (89.29%) had fever, 114 (81.43%) had cough, and 66\n'
'(47.1%) had malaise. Combination of two or more symptoms were found in\n'
'90% patients. Mean length of hospitalization was slightly longer in the\n'
'combination group than in the azvudine and paxlovid groups. Four deaths,\n'
'all in the A+P group; five cases of loss of function, two in the\n'
'paxlovid group and three in the A+P group; and acute kidney injury\n'
'occurred in 30 patients with 7 in the azvudine, 17 in paxlovid, and 6 in\n'
'A+P groups. Conclusion The use of small-molecule medications may be the\n'
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'the patients’ conditions, such as clinical symptoms, laboratory results,\n'
'paraclinicals, and examinations.</jats:p>',
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