The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience

The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience

Objectives Effectiveness of nirmatrelvir/ritonavir (NR) in kidney transplant recipients (KTRs) infected COVID-19 for more than 5 days has not been evaluated.Methods In this multicenter retrospective study, 85 KTRs with COVID-19 were enrolled, including 50 moderate, 21 severe, and 14 critical patient...

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Main Authors: Huanxi Zhang, Wenrui Wu, Yitao Zheng, Qian Fu, Peisong Chen, Jianyi Li, Zixuan Wu, Jincui Gu, Jun Li, Longshan Liu, Chenglin Wu, Sizhe Long, Bowen Xu, Liuting Ling, Yingxin Fu, Changxi Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
Subjects:
Nirmatrelvir/ritonavir
SARS-CoV-2
COVID-19
kidney transplantation
efficacy
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2385724
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Summary:Objectives Effectiveness of nirmatrelvir/ritonavir (NR) in kidney transplant recipients (KTRs) infected COVID-19 for more than 5 days has not been evaluated.Methods In this multicenter retrospective study, 85 KTRs with COVID-19 were enrolled, including 50 moderate, 21 severe, and 14 critical patients.Results The median time from onset to starting NR treatment was 14 (IQR, 11–19) days. Before NR treatment, 96.5% patients reduced use of antimetabolites. They also stopped using calcineurin inhibitors (CNI) 12–24 hours before NR treatment, with CNI concentrations well-controlled during NR treatment. The use of intravenous corticosteroids increased with COVID-19 severity. The median time to reach viral negative conversion was 5 (IQR, 4–8) days for all patients. For moderate and severe COVID-19 patients, they had a low rate of ICU admission (1.4%), exacerbation requiring upgraded oxygen therapy (5.6%), and dialysis (2.8%); no intubation and mechanical ventilation, and no deaths were observed. Patients with critical COVID-19 had a low mortality rate (7.1%).Conclusions A regimen including NR for clearing SARS-CoV-2 along with reducing immunosuppressants and using intravenous corticosteroids is associated with lower rates of exacerbation and mortality in KTRs who have moderate to critical SARS-CoV-2 infection and the virus still present after 5 days.
ISSN:0886-022X
1525-6049

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