Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 1;106(11):2200-2204.
doi: 10.1097/TP.0000000000004306. Epub 2022 Aug 2.

Preliminary Clinical Experience of Molnupiravir to Prevent Progression of COVID-19 in Kidney Transplant Recipients

Miguel Villamarín  1 , Ester Márquez-Algaba  1 , Juliana Esperalba  2 , Manuel Perelló  3 , Ibai Los Arcos  1 , David Campany  4 , Francisco Moreso  3 , Oscar Len  1   5
Affiliations

Preliminary Clinical Experience of Molnupiravir to Prevent Progression of COVID-19 in Kidney Transplant Recipients

Miguel Villamarín et al. Transplantation. .

Abstract

Background: Recently, different therapeutic lines have been tried in the initial stage of the disease of COVID-19, including remdesivir and molnupiravir. There is scarce evidence on the efficacy and safety of molnupiravir in kidney transplant recipients (KTRs).

Methods: ingle-center prospective cohort study' all adult KTRs diagnosed with COVID-19 and treated with molnupiravir or remdesivir from January to April 2022 were included.

Results: Nine KTRs with SARS-CoV-2 (Omicron variant) infection and mild symptoms received molnupiravir in an outpatient basis and were compared with a cohort of similar patients treated with remdesivir (n = 7). Three patients in the molnupiravir cohort were in the early posttransplant period and received a basiliximab (n = 2) or antithymocite globulin-based induction (n = 1). One of the patients had been treated with methylprednisolone bolus and antithymocite globulin for an episode of acute rejection in the previous months. They were all vaccinated with mRNA vaccines' and all but 1 had serological response. Only one of the patients experienced clinical worsening despite molnupiravir treatment and developed pneumonia requiring hospital admission. None of the patients suffered adverse effects attributed to molnupiravir' and no adjustment of tacrolimus dose was needed. None of the patients treated with remdesivir progressed in COVID-19 severity.

Conclusions: Our study suggests that KTRs with SARS-CoV-2 infection under treatment with molnupiravir have a good clinical evolution with a probable lower risk for hospitalization and no adverse effects. At the renal level, molnupiravir was well tolerated, with no evidence of nephrotoxicity secondary to the drug nor interactions with the immunosuppressive therapy.

PubMed Disclaimer

Conflict of interest statement

I.L.A. has been a speaker for Merck and Pfizer and has received travel support from Gilead, Merck‚ and Novartis. O.L. has received a research grant from Pfizer and has been a speaker for Pfizer, Astellas, Novartis‚ and Merck. The authors declare no conflicts of interest.

References

    1. Medina-Pestana J, Cristelli MP, Foresto RD, et al. The higher COVID-19 fatality rate among kidney transplant recipients calls for further action. Transplantation. 2022;106:908–910.
    1. Gentile I, Maraolo AE, Buonomo AR, et al. Monoclonal antibodies against SARS-CoV-2: potential game-changer still underused. Int J Environ Res Public Health. 2021;18:11159.
    1. Liu L, Iketani S, Guo Y, et al. Striking antibody evasion manifested by the Omicron variant of SARS-CoV-2. Nature. 2022;602:676–681.
    1. Gottlieb RL, Vaca CE, Paredes R, et al. Early remdesivir to prevent progression to severe Covid-19 in outpatients. N Engl J Med. 2022;386:305–315.
    1. Colaneri M, Amarasinghe N, Rezzonico L, et al. Early remdesivir to prevent severe COVID-19 in recipients of solid organ transplant: a real-life study from Northern Italy. Int J Infect Dis. 2022;121:157–160.

Supplementary concepts