Abstract
Background
Favipiravir (FPV) is an orally administrable antiviral drug that selectively inhibits RNA-dependent RNA polymerase and has been repurposed for COVID-19 treatment. There is limited information on the use of FPV in kidney transplant recipients (KTx), who often have multiple comorbidities and run a higher risk for death from COVID-19.
Methods
We retrospectively reviewed all KTx at our institution who got sick with COVID-19 between March 1, 2020, and May 31, 2021, and who received FPV (loading dose of 1800 mg × 2 on day 1, maintenance dose 2 × 800 mg/d for 5-14 days) as part of their COVID treatment. We analyzed demographics, clinical course, laboratory data, management, and outcome.
Results
Nine KTx with COVID-19 received FPV; all were hospitalized. The median age was 52 years (range, 32-60 years), and women were predominant (77.7%). Eight KTx had pulmonary involvement on chest radiograph. On admission 1 patient had mild, 5 had moderate, 2 had severe, and 1 had critical disease. Leukopenia and increased creatinine were universally noted. Three patients had disease progression under treatment. Seven patients (77.7%) required additional oxygen, and 4 (57.1%) needed intensive care unit admission. Three KTx died, resulting in an overall mortality of 33.3%. Survivors did not show increased transaminases or creatinine during or after FPV treatment; leukocytes, neutrophils, and platelets improved on discharge compared with admission values.
Conclusions
FPV appears well tolerated by KTx with COVID-19, but its clinical benefit remains unclear. Larger analyses are needed.
【초록키워드】 COVID-19, Treatment, Neutrophils, Hospitalized, intensive care, oxygen, outcome, discharge, antiviral drug, COVID, Disease progression, Clinical course, management, Chest, Patient, death, Platelet, Mild, RNA-dependent RNA polymerase, women, information, Admission, moderate, kidney transplant recipient, Critical disease, leukocytes, creatinine, Analysis, demographics, Loading dose, higher risk, overall mortality, maintenance dose, median age, laboratory data, clinical benefit, pulmonary involvement, transaminase, Result, resulting, analyzed, died, inhibit, required, appear, sick, predominant, FPV, multiple comorbidity, with COVID-19, 【제목키워드】 Transplant, recipient, Sery,