Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand?
Abstract Background The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-vir...
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2021
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oai:doaj.org-article:eac925369cb847e99d332d05592db2282021-11-28T12:03:04ZEvaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand?10.1186/s12985-021-01700-21743-422Xhttps://doaj.org/article/eac925369cb847e99d332d05592db2282021-11-01T00:00:00Zhttps://doi.org/10.1186/s12985-021-01700-2https://doaj.org/toc/1743-422XAbstract Background The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-viral and immunomodulator medications effect in treating COVID-19 patients to this date. Method This retrospective study was conducted in Shiraz Transplant Hospital, Iran from March 2020 to May 2021 and included COVID-19 diagnosed patients based on SARS-CoV-2 RT-PCR positive test who had been hospitalized for at least 48 h before enrolling in the study. Clinical and demographic information of patients, along with their treatment course and the medication used were evaluated and analyzed using multiple regression analysis. Results A total of 245 patients with a mean age of 49.59 years were included with a mortality rate of 8.16%. The administration of Remdesivir as an anti-viral drug (P value < 0.001) and Tocilizumab as an immunomodulator drug (P value < 0.001) could reduce the hospitalization period in the hospital and the intensive care unit, as well as the mortality rates significantly. Meanwhile, the patients treated with Lopinavir/Ritonavir experienced a lower chance of survival (OR < 1, P value = 0.04). No significant difference was observed between various therapeutic regimens in clinical complications such as bacterial coinfections, cardiovascular and gastrointestinal adverse reactions, and liver or kidney dysfunctions. Conclusion The administration of Remdesivir as an anti-viral and Tocilizumab as an immunomodulatory drug in solid-organ transplant recipients could be promising treatments of choice to manage COVID-19.Mojtaba ShafiekhaniFarbod ShahabinezhadTahmoores NiknamSeyed Ahmad TaraElham HaemParviz MardaniZahra ZareSedigheh JafarianKhatereh Mirzad JahromiSara ArabsheybaniYalda Sadat MoeiniJalile AlaviSeyed Soroush JalaliMaryam SalimiReza ShahriariradSeyed Ali MalekhosseiniBMCarticleCOVID-19Coronavirus disease 2019TransplantTocilizumabRemdesivirInfectious and parasitic diseasesRC109-216ENVirology Journal, Vol 18, Iss 1, Pp 1-10 (2021) |
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DOAJ |
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COVID-19 Coronavirus disease 2019 Transplant Tocilizumab Remdesivir Infectious and parasitic diseases RC109-216 |
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COVID-19 Coronavirus disease 2019 Transplant Tocilizumab Remdesivir Infectious and parasitic diseases RC109-216 Mojtaba Shafiekhani Farbod Shahabinezhad Tahmoores Niknam Seyed Ahmad Tara Elham Haem Parviz Mardani Zahra Zare Sedigheh Jafarian Khatereh Mirzad Jahromi Sara Arabsheybani Yalda Sadat Moeini Jalile Alavi Seyed Soroush Jalali Maryam Salimi Reza Shahriarirad Seyed Ali Malekhosseini Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| description |
Abstract Background The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-viral and immunomodulator medications effect in treating COVID-19 patients to this date. Method This retrospective study was conducted in Shiraz Transplant Hospital, Iran from March 2020 to May 2021 and included COVID-19 diagnosed patients based on SARS-CoV-2 RT-PCR positive test who had been hospitalized for at least 48 h before enrolling in the study. Clinical and demographic information of patients, along with their treatment course and the medication used were evaluated and analyzed using multiple regression analysis. Results A total of 245 patients with a mean age of 49.59 years were included with a mortality rate of 8.16%. The administration of Remdesivir as an anti-viral drug (P value < 0.001) and Tocilizumab as an immunomodulator drug (P value < 0.001) could reduce the hospitalization period in the hospital and the intensive care unit, as well as the mortality rates significantly. Meanwhile, the patients treated with Lopinavir/Ritonavir experienced a lower chance of survival (OR < 1, P value = 0.04). No significant difference was observed between various therapeutic regimens in clinical complications such as bacterial coinfections, cardiovascular and gastrointestinal adverse reactions, and liver or kidney dysfunctions. Conclusion The administration of Remdesivir as an anti-viral and Tocilizumab as an immunomodulatory drug in solid-organ transplant recipients could be promising treatments of choice to manage COVID-19. |
| format |
article |
| author |
Mojtaba Shafiekhani Farbod Shahabinezhad Tahmoores Niknam Seyed Ahmad Tara Elham Haem Parviz Mardani Zahra Zare Sedigheh Jafarian Khatereh Mirzad Jahromi Sara Arabsheybani Yalda Sadat Moeini Jalile Alavi Seyed Soroush Jalali Maryam Salimi Reza Shahriarirad Seyed Ali Malekhosseini |
| author_facet |
Mojtaba Shafiekhani Farbod Shahabinezhad Tahmoores Niknam Seyed Ahmad Tara Elham Haem Parviz Mardani Zahra Zare Sedigheh Jafarian Khatereh Mirzad Jahromi Sara Arabsheybani Yalda Sadat Moeini Jalile Alavi Seyed Soroush Jalali Maryam Salimi Reza Shahriarirad Seyed Ali Malekhosseini |
| author_sort |
Mojtaba Shafiekhani |
| title |
Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| title_short |
Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| title_full |
Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| title_fullStr |
Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| title_full_unstemmed |
Evaluation of the therapeutic regimen in COVID-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| title_sort |
evaluation of the therapeutic regimen in covid-19 in transplant patients: where do immunomodulatory and antivirals stand? |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/eac925369cb847e99d332d05592db228 |
| work_keys_str_mv |
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1718408293317083136 |