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. 2024 Sep 26:37:12920.
doi: 10.3389/ti.2024.12920. eCollection 2024.

Management of Kidney Transplant Outpatients With COVID-19: A Single Center Experience

Michaela Matysková Kubišová  1 , Sylvie Dusilová Sulková  1 , Petr Moučka  1 , Anita Pokorná  1 , Marcela Heislerová  2 , Igor Guňka  3 , Pavel Navrátil  4 , Jaroslav Pacovský  4 , Alena Malá  1 , Roman Šafránek  1
Affiliations

Management of Kidney Transplant Outpatients With COVID-19: A Single Center Experience

Michaela Matysková Kubišová et al. Transpl Int. .

Abstract

Patients undergoing kidney transplant are at risk of severe COVID-19. Our single-center retrospective analysis evaluated the outcomes of kidney transplant outpatients with COVID-19 who were managed with reduced immunosuppression and treatment with molnupiravir. Between January 2022 and May 2023, we included 93 patients (62 men, average age 56 years), serum creatinine 127 (101-153) µmol/L. Molnupiravir was administered, and immunosuppressive therapy was reduced immediately following the confirmation of SARS-CoV-2 infection by PCR, which was 2 (1-3) days after the onset of symptoms. Only three (3.2%) patients required hospitalization, and one patient died. Acute kidney injury was observed in two patients. During the follow-up period of 19 (15-22) months, there was no significant increase in proteinuria, no acute or new chronic graft rejection, and kidney graft function remained stable; serum creatinine was 124 (106-159) µmol/L post-COVID-19 infection and 128 (101-161) µmol/L at the end of the follow-up period. Our results demonstrate that early initiation of molnupiravir treatment combined with a temporary reduction in immunosuppressive therapy results in favorable clinical outcomes in patients with COVID-19, with preservation of good graft function and no episodes of graft rejection.

Keywords: COVID-19; Sars-CoV-2; antiviral drugs; kidney transplantation; molnupiravir.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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