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Review
. 2021 Dec;43(1):273-280.
doi: 10.1080/0886022X.2021.1876730.

Immunosuppression in kidney transplant recipients with COVID-19 infection - where do we stand and where are we heading?

Ahmed Daoud  1 , Ahmad Alqassieh  2 , Duaa Alkhader  2 , Maria Aurora Posadas Salas  2   3 , Vinaya Rao  2   3 , Tibor Fülöp  3   4 , Karim M Soliman  2   3
Affiliations
Review

Immunosuppression in kidney transplant recipients with COVID-19 infection - where do we stand and where are we heading?

Ahmed Daoud et al. Ren Fail. 2021 Dec.

Abstract

The appropriate immunosuppressive regimen in kidney transplant recipients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2/COVID-19) infection remains unclear. The impact of direct virus injury complicated by dysregulated hyperimmune response with overwhelming release of various cytokines in COVID-19 infected subjects contributes to the complexity of management. The largest concern of the practicing clinicians at current time is how to tailor maintenance immune-modulating therapy during active viral infection and the efficacy of the soon-to-be upcoming immunization for COVID-19. This targeted review aims to cover most of the current evidence on the effect of key maintenance immunosuppressive agents in COVID-19 infection and proposes a line of management to specific scenarios on this very rapidly evolving subject.

Keywords: COVID-19; kidney transplant; bamlanivimab; immunosuppression; ivermectin; CNI..

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Conflict of interest statement

Dr Tibor Fülöp is a current employee of the United States Veterans Health Administration. However, the views and opinions expressed herewith do not reflect the official views or opinion or endorsed by the United States Veteran Health Administrations.

Figures

Figure 1.
Figure 1.
Proposed algorithm for immunosuppressive management in kidney transplant recipients with COVID-19 infection.
See this image and copyright information in PMC

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