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May 2, 20260 citations

Safety and efficacy of nirmatrelvir and ritonavir in kidney transplant recipients with COVID-19.

YWYadi Wang KZKeqin ZhangShanghai University of Traditional Chinese Medicine LLLing Liu

Key Points

This research aims to evaluate the safety and efficacy of nirmatrelvir and ritonavir in kidney transplant recipients with COVID-19.
Monitored renal and hepatic function through serum creatinine and liver enzyme levels from admission to discharge.
Analyzed T-cell counts as potential indicators of acute respiratory distress syndrome (ARDS).
Evaluated complications throughout the treatment period.
Serum creatinine showed significant reduction (p < 0.001) from admission to discharge.
Aspartate aminotransferase levels decreased significantly (p = 0.01), indicating improved liver function.
Complications occurred in only 2 patients, demonstrating the safety of the treatment regimen.

Abstract

T-cell counts (OR = 0.982, 95% CI 0.968 - 0.998) as protective against ARDS, with an AUC of 0.859. Significant reductions in serum creatinine (p < 0.001) and aspartate aminotransferase (p = 0.01) were observed from admission to discharge, while alanine aminotransferase and estimated glomerular filtration rate (eGFR) remained stable. Complications were rare, occurring in only 2 patients. NR therapy demonstrated safety and effectiveness in KTRs, evidenced by improvements in renal and hepatic function as well as stable graft outcomes. CD4+ T-cell counts and albumin levels were identified as potential predictors of ARDS. These findings underscore the significance of early antiviral intervention and meticulous optimization of immunosuppressive management. However, further validation through larger multicenter prospective studies is necessary.

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