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

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

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..

Publication types

  • Review

MeSH terms

  • Algorithms
  • COVID-19 / complications*
  • Humans
  • Immunosuppression Therapy*
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation*
  • Renal Insufficiency / complications*
  • Renal Insufficiency / surgery*

Substances

  • Immunosuppressive Agents