The pattern, pharmacotherapy course, drug-drug interactions, and clinical outcome of COVID-19 in kidney transplant patients at a referral transplantation hospital in Iran: A retrospective, observational study

Document Type : Original Article

Authors

1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction: Kidney transplant recipients are at higher risk of developing COVID-19. The aim of this study was to evaluate the pattern, pharmacotherapy, drug interactions, and clinical outcome of COVID-19 in kidney transplant recipients at a referral center in Iran.
Methods: This retrospective, observational study was conducted in Buali Sina Transplantation hospital in Shiraz, Iran. All adult (≥18 years old) kidney transplant patients diagnosed with COVID-19 and hospitalized for at least 48 hours were included. Required demographic, clinical, and paraclinical features of patients were collected. Potential drug-drug interactions were identified using Lexi-Interact online software as well as the Liverpool interactions online website.
Results: A total of 108 patients were included. Fever, cough, and shortness of breath were the most common clinical symptoms of the patients. About three-fourth (74%) of patients had non-severe COVID-19. Remdesivir is the most widely used antiviral agent. mTOR inhibitors and anti-metabolites were undergone either dose reduction or discontinuation in 100% and 80.2% of cases, respectively. Age (OR = 1.055, 95% Cl = 1.015-1.097), calcineurin inhibitor adjustment (OR = 0.264, 95% Cl = 0.093-0.750), baseline white blood cell count (OR = 1.134, 95% Cl = 1.009-1.275), baseline serum lactate dehydrogenase level (OR = 1.317, 95% Cl = 1.028-1.686), administration of tocilizumab (OR = 0.057, 95% Cl = 0.006-0.535), and the severity of COVID-19 disease (OR = 0.003 , 95% Cl = 0.00-0.03) had significant association with mortality.
Conclusion: Our investigation found that COVID-19 infection in kidney transplant patients may be severe and require hospitalization and even, intensive care.

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