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

Kidney transplant recipients are at higher risk of developing coronavirus disease 2019 (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. this retrospective, observational study was conducted in abu ali sina organ transplantation center in shiraz, iran. all adult kidney transplant patients diagnosed with covid-19 and hospitalized for at least 48 hours were included. required data were collected by reviewing medical charts and health information system of patients at hospital. potential drug-drug interactions were identified using lexi-interact online as well as the liverpool interactions online website. a total of 108 patients were included. fever, cough, and shortness of breath were the most common clinical symptoms. about three-fourth (74%) of patients had non-severe covid-19. remdesivir was the most widely used antiviral agent. mtor inhibitors and anti-metabolites were either dose reduced or discontinued in 100% and 80.2% of cases, respectively. age (odds ratio [or] = 1.06, 95% [cl] = 1.02-1.09), calcineurin inhibitor adjustment (or = 0.26, 95% cl = 0.09-0.75), baseline white blood cell count (or = 1.13, 95% cl = 1.01-1.28), baseline serum lactate dehydrogenase level (or = 1.32, 95% cl = 1.03-1.69), administration of tocilizumab (or = 0.06, 95% cl = 0.07-0.54), and the severity of covid-19 disease (or = 0.03, 95% cl = 0.00-0.03) had significant association with mortality.  the present investigation found that covid-19 infection in kidney transplant patients may be severe and require hospitalization and even, critical care.