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Néphrologie & Thérapeutique

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COVID-19 early curative treatments in kidney transplant recipients: is it really reasonable at the Omicron era? Volume 19, issue 6, October 2023

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Authors
1 Sorbonne Université, 75013 Paris, France
2 AP-HP, Pitié-Salpétrière, Medicosurgical Unit of Kidney Transplantation, 75013 Paris, France
3 AP-HP, Pitié-Salpétrière, Infectious Diseases Department, 75013 Paris, France
4 AP-HP, Pitié-Salpétrière, Department of virology, 75013 Paris, France
5 AP-HP, Pitié-Salpétrière, Department of pharmacy, 75013 Paris, France
6 Inserm UMR 1155, 75020 Paris, France
7 Inserm UMR 1038, 75013 Paris, France
8 Inserm UMR 1136, 75013 Paris, France
8 Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLSEP), 75013 Paris, France
9 Inserm UMR 1139, 75013 Paris, France
* These authors contributed equally to this work
Correspondance : Y. Tamzali
yanis.tamzali@aphp.fr

Objective

Data about efficacy and safety of the latest COVID-19 treatments as nirmatrelvir/ritonavir (n/r) or Sotrovimab is scarce in solid organ transplant recipients in the Omicron era. This study aims at describing the outcome of kidney transplant recipients (KTRs) presenting Omicron infection according to their management: n/r, sotrovimab or no specific treatment.

Patients and methods

We conducted a monocentric, retrospective observational study, including KTRs diagnosed Omicron infection between January and May 1st 2022 and compared their outcome (primary outcome defined as hospital admission for COVID-19 within a month after symptoms onset) according to early COVID-19 management.

Results

Forty-five patients were included: 22 treated (12 n/r, 10 sotrovimab) and 23 with no specific treatment. The groups were statistically comparable. Two patients were admitted for COVID-19: one in each group, resulting in a non-different probability of the primary outcome at on month (p=0.9). Three patients presented tacrolimus overdose including two with acute kidney injury.

Conclusions

There was no difference in outcome according to early therapeutic management: n/r, sotrovimab or no specific treatment. Our study both underlines a decreased severity of Omicron COVID-19 in KTRs (probably related to vaccinal immunity and decreased virulence of Omicron) and a potential severe adverse effects with n/r.