Few reports described the outcome of kidney transplanted patients (KTs) affected by COVID-19 treated with interleukin-6 receptor inhibitor Tocilizumab (TCZ). We report our case series of 6 KTs with COVID-19 pneumonia who received TCZ: all were of male gender, with a mean age of 55.5±8.4 years, a median time from transplantation of 3611 days (1465-5757); 5/6 had cardiovascular comorbidities, 1/6 had diabetes and 3/6 have one or more previous KTs. Four out of six patients died, at an average time of 9.75±2.4 days after tocilizumab administration, 3/6 due to a coexistent septic shock. Two patients improved after TCZ and were discharged at 20 and 21 days respectively; in both patient a significant increase of total lymphocyte count was observed. In conclusion KTs, where the role of peculiar factors such as chronic immunosuppression is still undetermined, represent a high-risk group with significant COVID-19 associated mortality. The evaluation of the TCZ effect in COVID-19 pneumonia requires controlled studies (ideally RCTs) in this specific population.

Case series of six kidney transplanted patients with COVID-19 pneumonia treated with tocilizumab

Mella, Alberto
First
;
Mingozzi, Silvia;Gallo, Ester;Lavacca, Antonio;Clari, Roberta;Randone, Olga;Biancone, Luigi
2020

Abstract

Few reports described the outcome of kidney transplanted patients (KTs) affected by COVID-19 treated with interleukin-6 receptor inhibitor Tocilizumab (TCZ). We report our case series of 6 KTs with COVID-19 pneumonia who received TCZ: all were of male gender, with a mean age of 55.5±8.4 years, a median time from transplantation of 3611 days (1465-5757); 5/6 had cardiovascular comorbidities, 1/6 had diabetes and 3/6 have one or more previous KTs. Four out of six patients died, at an average time of 9.75±2.4 days after tocilizumab administration, 3/6 due to a coexistent septic shock. Two patients improved after TCZ and were discharged at 20 and 21 days respectively; in both patient a significant increase of total lymphocyte count was observed. In conclusion KTs, where the role of peculiar factors such as chronic immunosuppression is still undetermined, represent a high-risk group with significant COVID-19 associated mortality. The evaluation of the TCZ effect in COVID-19 pneumonia requires controlled studies (ideally RCTs) in this specific population.
22
6
e13348
e13348
Mella, Alberto; Mingozzi, Silvia; Gallo, Ester; Lavacca, Antonio; Rossetti, Maura Maria; Clari, Roberta; Randone, Olga; Maffei, Stefano; Salomone, Mario; Imperiale, Daniele; Biancone, Luigi
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1741494
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