Tag: Organ transplant recipients

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Immunosuppressive Drugs Linked to COVID-19 Hospitalization in Organ Transplant Recipients

In a recent cohort study involving 60,456 solid organ transplant recipients, researchers have identified a potential association between certain immunosuppressive drugs and an increased risk of COVID-19-related hospitalization. The study, conducted using the French National Health Data System, aimed to explore the factors influencing the severity of COVID-19 in this vulnerable population.

Key Findings:

  • Mycophenolic Acid and Steroids: The study revealed that mycophenolic acid and steroids were associated with a higher risk of COVID-19 hospitalization, with a relative risk increase ranging from 29% to 72%. These drugs, commonly used to prevent graft rejection, showed a dose-related association with hospitalization.
  • Tacrolimus and Cyclosporine: In contrast, tacrolimus and cyclosporine, particularly in liver and heart transplant patients, were associated with a decreased risk of hospitalization. Liver transplant patients on tacrolimus showed a 23% decreased risk, while heart transplant patients on cyclosporine had a 33% decreased risk.

Organ-Specific Associations:

  • Kidney Transplants: Kidney transplant recipients using steroids and mycophenolic acid had a higher risk of hospitalization. Age, social deprivation index, obesity, and diabetes were also identified as risk factors.
  • Liver Transplants: Tacrolimus was linked to a reduced risk, while steroids and mycophenolic acid were associated with an increased risk of hospitalization. Age, hypertension, diabetes, and dialysis were identified as additional risk factors.
  • Heart Transplants: Cyclosporine was associated with a decreased risk, while steroids, mycophenolic acid, sirolimus, and everolimus were linked to an increased risk of hospitalization. Obesity, diabetes, and dialysis were identified as additional risk factors.
  • Lung Transplants: Steroids were the only factor associated with a high risk of COVID-19 hospitalization in lung transplant recipients.

Implications: These findings highlight the complex interplay between immunosuppressive therapies and COVID-19 outcomes in organ transplant recipients. The study suggests that tailoring immunosuppressive drug regimens based on the type of transplant and individual patient factors could be crucial in managing the risk of severe COVID-19.

Conclusion: The study urges healthcare professionals to consider these results in the treatment of solid organ transplant recipients infected with SARS-CoV-2. Adjusting medication doses or modifying regimens based on individual patient profiles may contribute to better outcomes. The findings could also guide public health decisions for this population during future epidemics. However, the researchers emphasize the need for further studies to strengthen and consolidate these initial findings.

Credit: Epiphane Kolla, JAMA Network Open

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Study Finds Immunosuppressive Drugs Impact COVID-19 Hospitalization Risk in Organ Transplant Recipients

Mycophenolic Acid and Steroids Increase Risk, while Tacrolimus and Cyclosporine Decrease Risk

In a groundbreaking study of 60,456 solid organ transplant recipients, researchers have identified the impact of immunosuppressive drugs on COVID-19-related hospitalization risk. The study revealed that maintenance therapy with these drugs significantly affects the outcomes of transplant recipients who contract COVID-19.

Key Findings:

  • Mycophenolic acid and steroids were associated with a higher risk of COVID-19 hospitalization, with a relative risk increase of 29%-72%.
  • In liver and heart transplant patients, tacrolimus and cyclosporine were linked to a decreased risk of hospitalization, with relative risk decreases of 23% and 33%, respectively.
  • These findings highlight the importance of closely monitoring solid organ transplant recipients during the COVID-19 pandemic.

Background:

Solid organ transplant recipients have an elevated risk of severe SARS-CoV-2 infection due to their immunosuppressed state, comorbidities, and other factors. Previous studies had indicated an increased risk of severe disease or death related to COVID-19 in this population, but the influence of various immunosuppressive therapies had not been thoroughly explored.

Methods:

  • The cohort study used data from the French National Health Data System and included patients of all ages who received transplants.
  • The study covered the period from February 15, 2020, to July 31, 2022.
  • Factors such as age, sex, comorbidities, time since transplant, and immunosuppressive drugs were examined.
  • The primary outcome was hospitalization for COVID-19.

Conclusion:

This study sheds light on the association between specific immunosuppressive drugs and the risk of COVID-19-related hospitalization in solid organ transplant recipients. Mycophenolic acid, sirolimus, and steroids were linked to an increased risk, while tacrolimus and cyclosporine were associated with a reduced risk of hospitalization. These findings have implications for the treatment of transplant recipients and may inform future epidemic-related decisions for this vulnerable population. Further research may be necessary to confirm these findings and refine treatment strategies.

Source & Credit: JAMA Network Open Journal