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
DOI record:
{
"DOI": "10.22541/au.168777909.90198442/v1",
"URL": "http://dx.doi.org/10.22541/au.168777909.90198442/v1",
"abstract": "<jats:p id=\"p1\">Background We analyzed the effects of small-molecule antiviral treatment\nfor coronavirus disease-2019 (COVID-19) Omicron strain in kidney\ntransplant recipients. Methods We enrolled 140 kidney transplant\npatients admitted for COVID-19-related pneumonia were treated using\nsmall-molecule antivirals. Patients were divided into three groups:\nazvudine (n=62), paxlovid (n=49), and a combination of azvudine+paxlovid\n(A+P, n=29). Differences in clinical outcomes owing to COVID-19\ninfections were compared among three groups. Results Paxlovid group had\na higher proportion of comorbid diabetes than the other two groups\n(P=0.032). There were differences in the clinical typing of the\ncoronavirus , with the highest proportion of heavy and critical cases in\nthe A+P group (35.5%). The immunosuppression prior to infection did not\ndiffer among the groups; however, after adjusting for immunosuppression\nduring antiviral treatment, differences were observed. Of the 140\npatients, 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\n90% patients. Mean length of hospitalization was slightly longer in the\ncombination group than in the azvudine and paxlovid groups. Four deaths,\nall in the A+P group; five cases of loss of function, two in the\npaxlovid group and three in the A+P group; and acute kidney injury\noccurred in 30 patients with 7 in the azvudine, 17 in paxlovid, and 6 in\nA+P groups. Conclusion The use of small-molecule medications may be the\noptimal treatment approach; however, they should be modified based on\nthe patients’ conditions, such as clinical symptoms, laboratory results,\nparaclinicals, and examinations.</jats:p>",
"accepted": {
"date-parts": [
[
2023,
6,
26
]
]
},
"author": [
{
"ORCID": "http://orcid.org/0000-0002-2247-8684",
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"authenticated-orcid": true,
"family": "Fu",
"given": "Yingxin",
"sequence": "first"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Pan",
"given": "Jianyong",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Chen",
"given": "Weijun",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Zheng",
"given": "Yitao",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Wu",
"given": "Zixuan",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Liu",
"given": "Yongdong",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Peng",
"given": "Yuanzheng",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Second Affiliated Hospital of Southern University of Science and Technology"
}
],
"family": "Lu",
"given": "Hongzhou",
"sequence": "additional"
}
],
"container-title": [],
"content-domain": {
"crossmark-restriction": false,
"domain": []
},
"created": {
"date-parts": [
[
2023,
6,
26
]
],
"date-time": "2023-06-26T11:31:39Z",
"timestamp": 1687779099000
},
"deposited": {
"date-parts": [
[
2023,
6,
26
]
],
"date-time": "2023-06-26T11:31:39Z",
"timestamp": 1687779099000
},
"group-title": "Preprints",
"indexed": {
"date-parts": [
[
2023,
6,
27
]
],
"date-time": "2023-06-27T04:35:24Z",
"timestamp": 1687840524403
},
"institution": [
{
"name": "Authorea, Inc."
}
],
"is-referenced-by-count": 0,
"issued": {
"date-parts": [
[
2023,
6,
26
]
]
},
"member": "9829",
"original-title": [],
"posted": {
"date-parts": [
[
2023,
6,
26
]
]
},
"prefix": "10.22541",
"published": {
"date-parts": [
[
2023,
6,
26
]
]
},
"publisher": "Authorea, Inc.",
"reference-count": 0,
"references-count": 0,
"relation": {},
"resource": {
"primary": {
"URL": "https://www.authorea.com/users/632878/articles/651497-comparison-of-the-different-medications-for-covid-19-in-kidney-transplant-recipients?commit=ab4741e389c91904de90a9ce527e183d368e45d0"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subtitle": [],
"subtype": "preprint",
"title": "Comparison of the Different Medications for COVID-19 in Kidney Transplant Recipients",
"type": "posted-content"
}
