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. 2020 Apr 27.
doi: 10.1002/phar.2410. Online ahead of print.

Managing COVID-19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid-sparing Immunosuppression

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Managing COVID-19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid-sparing Immunosuppression

Kristen M Johnson et al. Pharmacotherapy. .

Abstract

Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome virus (SARS-CoV-2) has become a global health care crisis. The Centers for Disease Control and Prevention (CDC) lists immunocompromised patients, including those requiring immunosuppression following renal transplantation, as high risk for severe disease from SARS-CoV-2. Treatment for other viral infections in renal transplant recipients often includes a reduction in immunosuppression; however, no current guidelines are available recommending the optimal approach to managing immunosuppression in the patients who are infected with SARS-CoV-2. It is currently advised to avoid corticosteroids in the treatment of SARS-CoV-2 outside of critically ill patients. Recently published cases describing inpatient care of COVID-19 in renal transplant recipients differ widely in disease severity, time from transplantation, baseline immunosuppressive therapy, and the modifications made to immunosuppression during COVID-19 treatment. This review summarizes and compares inpatient immunosuppressant management strategies of recently published reports in the renal transplant population infected with SARS-CoV-2 and discusses the limitations of corticosteroids in managing immunosuppression in this patient population.

Keywords: COVID-19; SARS-CoV-2; coronavirus; corticosteroid; immunosuppression; renal transplant.

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