The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience

Zhang, Huanxi1; Wu, Wenrui1; Zheng, Yitao2; Fu, Qian1; Chen, Peisong3; Li, Jianyi1; Wu, Zixuan2; Gu, Jincui4; Li, Jun1; Liu, Longshan1,5,6; Wu, Chenglin1; Long, Sizhe7; Xu, Bowen1; Ling, Liuting1; Fu, Yingxin2; Wang, Changxi1,5,6

2024-12-31

10.1080/0886022X.2024.2385724

RENAL FAILURE   影响因子和分区

0886-022X

1525-6049

ObjectivesEffectiveness of nirmatrelvir/ritonavir (NR) in kidney transplant recipients (KTRs) infected COVID-19 for more than 5 days has not been evaluated.MethodsIn this multicenter retrospective study, 85 KTRs with COVID-19 were enrolled, including 50 moderate, 21 severe, and 14 critical patients.ResultsThe median time from onset to starting NR treatment was 14 (IQR, 11-19) days. Before NR treatment, 96.5% patients reduced use of antimetabolites. They also stopped using calcineurin inhibitors (CNI) 12-24 hours before NR treatment, with CNI concentrations well-controlled during NR treatment. The use of intravenous corticosteroids increased with COVID-19 severity. The median time to reach viral negative conversion was 5 (IQR, 4-8) days for all patients. For moderate and severe COVID-19 patients, they had a low rate of ICU admission (1.4%), exacerbation requiring upgraded oxygen therapy (5.6%), and dialysis (2.8%); no intubation and mechanical ventilation, and no deaths were observed. Patients with critical COVID-19 had a low mortality rate (7.1%).ConclusionsA regimen including NR for clearing SARS-CoV-2 along with reducing immunosuppressants and using intravenous corticosteroids is associated with lower rates of exacerbation and mortality in KTRs who have moderate to critical SARS-CoV-2 infection and the virus still present after 5 days.

Nirmatrelvir/ritonavir SARS-CoV-2 COVID-19 kidney transplantation efficacy

SCI

英语

通讯

Science and Technology Planning Project of Guangzhou City["201903010058","202201011318"] ; National Natural Science Foundation of China["81870511","82170770"] ; First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China["2013A061401007","2017B030314018","2020B1212060026","2015B050501002","2020A0505020003"] ; Elite Talent Project of Guangdong Province[R09002] ; Major Clinical Technology Project, Municipal Health Commission, Guangzhou, China[2023 P-ZD15]

Urology & Nephrology

Urology & Nephrology

WOS:001313900300001

TAYLOR & FRANCIS LTD

Web of Science

1.Sun Yat Sen Univ, Affiliated Hosp 1, Organ Transplant Ctr, Guangzhou, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 2, Peoples Hosp Shenzhen 3, Organ Transplant Ctr,Natl Clin Res Ctr Infect Dis,, Shenzhen, Peoples R China
3.Sun Yat Sen Univ, Affiliated Hosp 1, Dept Lab Med, Guangzhou, Peoples R China
4.Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Guangzhou, Peoples R China
5.Guangdong Prov Key Lab Organ Donat & Transplant Im, Guangzhou, Peoples R China
6.Guangdong Prov Int Cooperat Base Sci & Technol Org, Guangzhou, Peoples R China
7.Sun Yat Sen Univ, Affiliated Hosp 1, Ctr Informat Technol & Stat, Guangzhou, Peoples R China

Zhang, Huanxi,Wu, Wenrui,Zheng, Yitao,et al. The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience[J]. RENAL FAILURE,2024,46(2).

Zhang, Huanxi.,Wu, Wenrui.,Zheng, Yitao.,Fu, Qian.,Chen, Peisong.,...&Wang, Changxi.(2024).The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience.RENAL FAILURE,46(2).

Zhang, Huanxi,et al."The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience".RENAL FAILURE 46.2(2024).