AUTHOR=Matysková Kubišová Michaela , Dusilová Sulková Sylvie , Moučka Petr , Pokorná Anita , Heislerová Marcela , Guňka Igor , Navrátil Pavel , Pacovský Jaroslav , Malá Alena , Šafránek Roman 

TITLE=Management of Kidney Transplant Outpatients With COVID-19: A Single Center Experience

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12920

DOI=10.3389/ti.2024.12920

ISSN=1432-2277

ABSTRACT=Kidney transplant patients are at risk of severe COVID-19 disease. Our single-center retrospective analysis focused on evaluating outcomes of kidney transplant outpatients with COVID-19 managed with reduction of immunosuppression and treatment with molnupiravir. Between January 2022 and May 2023 we included 93 patients (62 men, average age 56 years), serum creatinine 127 (101-153) µmol/l. Molnupiravir treatment was initiated, and immunosuppressive therapy was reduced immediately after a proof of PCR SARS-CoV2 positivity was obtained, 2 (1;-3) days after first COVID-19 disease symptoms appeared. During COVID-19 disease only 3 (3.2 %) of patients had to be hospitalized, and only one died. Acute kidney injury was observed only in 2 patients. During 19 (15-22) months follow-up we observed no significant increase in proteinuria, no acute or new chronic graft rejection and kidney graft function was stable; serum creatinine was 124 (106-159) µmol/l after COVID-19 disease, and 128 (101-161) µmol/l at the end of follow-up, respectively. Our experience demonstrates that early initiation of molnupiravir treatment with temporary reduction of immunosuppressive therapy resulted in good clinical outcomes of COVID-19 disease patients with preservation of good graft function and no episode of graft rejection.