Tocilizumab use in Kidney Transplant Patients with COVID‐19

A potential benefit of immunomodulatory agents such as tocilizumab (TCZ) has been reported in patients with coronavirus disease 2019 (COVID‐19) and severe pulmonary involvement. However, this therapy has been scarcely studied in kidney transplant (KT) recipients. Herein, we describe the clinical cou...

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Veröffentlicht in:Clinical transplantation 2020-11, Vol.34 (11), p.e14072-n/a
Hauptverfasser: Trujillo, Hernando, Caravaca‐Fontán, Fernando, Sevillano, Ángel, Gutiérrez, Eduardo, Fernández‐Ruiz, Mario, López‐Medrano, Francisco, Hernández, Ana, Aguado, José María, Praga, Manuel, Andrés, Amado
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container_end_page n/a
container_issue 11
container_start_page e14072
container_title Clinical transplantation
container_volume 34
creator Trujillo, Hernando
Caravaca‐Fontán, Fernando
Sevillano, Ángel
Gutiérrez, Eduardo
Fernández‐Ruiz, Mario
López‐Medrano, Francisco
Hernández, Ana
Aguado, José María
Praga, Manuel
Andrés, Amado
description A potential benefit of immunomodulatory agents such as tocilizumab (TCZ) has been reported in patients with coronavirus disease 2019 (COVID‐19) and severe pulmonary involvement. However, this therapy has been scarcely studied in kidney transplant (KT) recipients. Herein, we describe the clinical course and outcome of 10 KT patients with severe COVID‐19 that were treated with TCZ. Mean age of the study group was 54 ± 10 years (70% females), and 30% of the cases were within 6 months from transplant. Mycophenolate mofetil was discontinued in all cases upon admission, whereas baseline steroids were maintained and tacrolimus dose was reduced. Initial treatment included hydroxychloroquine, antibiotics, and prophylactic anticoagulation. Before treatment with TCZ, 3 patients were receiving high‐flow oxygen, 4 patients low‐flow oxygen and 1 case non‐invasive ventilation. All patients received a single dose of intravenous TCZ within a mean time of 7 ± 4 days since admission. During a median follow‐up of 16 days (IQR: 10‐29), 7 patients (70%) gradually improved and were finally discharged while three cases (30%) did not exhibited clinical improvement and ultimately died. In conclusion, although treatment with TCZ could be associated with improved clinical outcomes in a subset of KT recipients with COVID‐19, further studies are warranted before drawing firm conclusions.
doi_str_mv 10.1111/ctr.14072
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However, this therapy has been scarcely studied in kidney transplant (KT) recipients. Herein, we describe the clinical course and outcome of 10 KT patients with severe COVID‐19 that were treated with TCZ. Mean age of the study group was 54 ± 10 years (70% females), and 30% of the cases were within 6 months from transplant. Mycophenolate mofetil was discontinued in all cases upon admission, whereas baseline steroids were maintained and tacrolimus dose was reduced. Initial treatment included hydroxychloroquine, antibiotics, and prophylactic anticoagulation. Before treatment with TCZ, 3 patients were receiving high‐flow oxygen, 4 patients low‐flow oxygen and 1 case non‐invasive ventilation. All patients received a single dose of intravenous TCZ within a mean time of 7 ± 4 days since admission. During a median follow‐up of 16 days (IQR: 10‐29), 7 patients (70%) gradually improved and were finally discharged while three cases (30%) did not exhibited clinical improvement and ultimately died. 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During a median follow‐up of 16 days (IQR: 10‐29), 7 patients (70%) gradually improved and were finally discharged while three cases (30%) did not exhibited clinical improvement and ultimately died. 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source MEDLINE; Access via Wiley Online Library
subjects Adult
Aged
Antibodies, Monoclonal, Humanized - therapeutic use
coronavirus disease 2019
COVID-19 - drug therapy
COVID-19 - etiology
Female
Follow-Up Studies
Hospitalization
Humans
Immunologic Factors - therapeutic use
Kidney Transplantation
Male
Middle Aged
outcomes
Postoperative Complications - drug therapy
Retrospective Studies
severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
tocilizumab
Treatment Outcome
title Tocilizumab use in Kidney Transplant Patients with COVID‐19
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