Use of Anti-Cytokine Therapy in Kidney Transplant Recipients with COVID-19

• Main Authors: Marta Bodro, Frederic Cofan, Jose Ríos, Sabina Herrera, Laura Linares, María Angeles Marcos, Alex Soriano, Asunción Moreno, Fritz Diekmann
• Format: Article
• Language: English
• Published: MDPI AG 2021-04-01
• Series: Journal of Clinical Medicine
• Subjects: COVID-19; kidney transplantation; anti-cytokine therapy; mortality; infection
• Online Access: https://www.mdpi.com/2077-0383/10/8/1551

In the context of the coronavirus disease 2019 (COVID-19) pandemic, we aimed to evaluate the impact of anti-cytokine therapies (AT) in kidney transplant recipients requiring hospitalization due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This is an observational retrospective study, which included patients from March to May 2020. An inverse probability of treatment weighting from a propensity score to receive AT was used in all statistical analyses, and we applied a bootstrap procedure in order to calculate an estimation of the 2.5th and 97.5th percentiles of odds ratio (OR). outcomes were measured using an ordinal scale determination (OSD). A total of 33 kidney recipients required hospitalization and 54% of them received at least one AT, mainly tocilizumab (42%), followed by anakinra (12%). There was no statistical effect in terms of intensive care unit (ICU) admission, respiratory secondary infections (35% vs. 7%) or mortality (16% vs. 13%) comparing patients that received AT with those who did not. Nevertheless, patients who received AT presented better outcomes during hospitalization in terms of OSD ≥5 ((OR 0.31; 2.5th, 97.5th percentiles (0.10; 0.72)). These analyses indicate, as a plausible hypothesis, that the use of AT in kidney transplant recipients presenting with COVID-19 could be beneficial, even though multicenter randomized control trials using these therapies in transplanted patients are needed.