Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD.
Transplantation. 2022 Aug 1;106(8):1528-1537. doi: 10.1097/TP.0000000000004200. Epub 2022 Jul 22.
Major changes have occurred in therapeutics for coronavirus-19 (COVID-19) infection over the past 12-18 mo, most notably in early outpatient therapy. In most cases, solid organ transplant recipients were not included in the original clinical trials of these agents, so studies of real-world outcomes have been important in building our understanding of their utility. This review examines what is known about clinical outcomes in solid organ transplant recipients with newer therapies. SARS-CoV-2 monoclonal antibodies for early treatment or prophylaxis have likely prevented many hospitalizations and deaths. In addition, convalescent plasma, the oral drugs nirmatrelvir/ritonavir and molnupiravir, remdesivir for early outpatient treatment, anti-inflammatory therapy, and investigational virus-specific T-cell therapy will be discussed. Finally, the later consequences of COVID-19, such as secondary infections, long COVID symptoms, and persistent active infection, are identified as areas for future research.
过去 12-18 个月,冠状病毒-19(COVID-19)感染的治疗方法发生了重大变化,尤其是在早期门诊治疗方面。在大多数情况下,实体器官移植受者未被纳入这些药物的原始临床试验,因此对真实世界结果的研究对于我们了解其效用非常重要。本综述探讨了关于新型治疗方法的实体器官移植受者临床结局的已知情况。早期治疗或预防用 SARS-CoV-2 单克隆抗体可能预防了许多住院和死亡。此外,恢复期血浆、口服药物奈玛特韦/利托那韦和莫努匹韦、瑞德西韦早期门诊治疗、抗炎治疗和研究中的病毒特异性 T 细胞治疗也将进行讨论。最后,COVID-19 的后续后果,如继发感染、长 COVID 症状和持续的活动性感染,被确定为未来研究的领域。