Abstract:
Therapeutic management of solid organ transplant (SOT) recipients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), may challenge healthcare providers given a paucity of clinical data specific to this cohort. Herein, we summarize and review the studies that have formed the framework for current COVID-19 consensus management guidelines. Our review focuses on COVID-19 treatment options including monoclonal antibody products, antiviral agents such as remdesivir, and immunomodulatory agents such as corticosteroids, interleukin inhibitors, and kinase inhibitors. We highlight the presence or absence of clinical data of these therapeutics related to the SOT recipient with COVID-19. We also describe data surrounding COVID-19 vaccination of the SOT recipient. Understanding the extent and limitations of observational and clinical trial data for the prevention and treatment of COVID-19 specific to the SOT population is crucial for optimal management. Although minimal data exist on clinical outcomes among SOT recipients treated with varying COVID-19 therapeutics, reviewing these agents and the studies that have led to their inclusion or exclusion in clinical management of COVID-19 highlights the need for further studies of these therapeutics in SOT patients with COVID-19.
摘要:
感染严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)的实体器官移植(SOT)受者的治疗管理,2019年冠状病毒病的病因(COVID-19),鉴于缺乏特定于该队列的临床数据,可能会挑战医疗保健提供者。在这里,我们总结并回顾了构成当前COVID-19共识管理指南框架的研究.我们的审查重点是COVID-19治疗方案,包括单克隆抗体产品,抗病毒剂如remdesivir,免疫调节剂如皮质类固醇,白细胞介素抑制剂,和激酶抑制剂。我们强调了这些治疗方法是否存在与COVID-19的SOT接受者相关的临床数据。我们还描述了SOT接受者的COVID-19疫苗接种数据。了解针对SOT人群的COVID-19预防和治疗的观察和临床试验数据的范围和局限性对于优化管理至关重要。尽管接受不同COVID-19疗法治疗的SOT接受者的临床结果数据很少,回顾这些药物以及导致将其纳入或排除在COVID-19临床治疗中的研究,强调需要进一步研究这些治疗方法在SOTCOVID-19患者中的应用。