TABLE 1.
Management of mTOR-I therapy and outcomes in kidney transplant recipients with COVID-19
| Drug | N° of patients in mTOR-I | Management of mTOR-I | Clinical outcome | Reference |
|---|---|---|---|---|
| mTOR-Ia | 29/243 admitted to hospital | During hospitalization mTOR-Is were withdrawn in 18/29 (62.1%) | 8 developed nonsevere COVID-19 and 10 developed severe COVID-19 200 pts survived (22 were in mTOR-I); 43 died (7 were in mTOR-I) No significant association between clinical outcome and mTOR-I |
Caillard et al. (2020) |
| mTOR-Ia | 131/778 SOT and HSCT recipients (423 kidney transplant recipients) | 49 no adjustment; 13 dose reduction; 69 withdrawal | 31 pts died (8 in the group of no adjustment, 1 in the dose reduction group and 22 after withdrawal). 47 pts developed ARDS (13 in the group of no adjustment, 1 in the dose reduction group and 33 after withdrawal) No outcome differences were found according to the type of baseline immunosuppression |
Coll et al. (2021) |
| mTOR-Ia | 20/104 (19.3%) | Withdrawn in 12 patients (60%) | 76 survived (21.6% were in mTOR-I) and 28 died (3.9% were in mTOR-I) 57 pts developed ARDS (20% were in mTOR-I) 47 pts did not develop ARDS (31.9% were in mTOR-I) No relationship between type of immunosuppression modification and mortality. |
Favà et al. (2020) |
| mTOR-Ia | 14% of 305 (34 pts not admitted and 271 admitted to hospital) | 86% no adjustment; 3% dose reduction; 11% withdrawal | 207 survived (86% no adjustment; 3% dose reduction; 11% withdrawal) 64 died (87% no adjustment; 0 dose reduction; 13% withdrawal) 213 pts in ICU (14% were in mTOR-I) and 58 pts not ICU (19% were in mTOR-I) |
Hilbrands et al. (2020) |
| mTOR-Ia | 14/80 (17.5%) | 26 (33.8%) only MMF or mTOR-I withdrawal 43 (55.8%) both CNI and MMF or mTOR-I withdrawal |
54 survived (18.5% were in mTOR-I) 26 died (15.4% were in mTOR-I) In the group of pts with only MMF or mTOR-I withdrawal 15 survived and 11 died In the group of pts with both CNI and MMF or mTOR-I withdrawal 31 survived and 12 died |
Pérez-Sáez et al. (2020) |
| SRL/EVE | 49/210 SOT (23.3%) 108 kidney transplant recipients |
mTOR-I was decreased or stopped in 35/49 (71.4%) | 26 with favorable outcome (full recovery and discharged or stable clinical condition) and 9 with unfavorable outcome (ICU admission and/or death) | Salto-Alejandre et al. (2021) |
| mTOR-Ia | 14/230 SOT (6.1%) 162 kidney transplant recipients |
mTOR-I was decreased or stopped in 2/14 | 9 inpatients and 5 outpatients 2 patients in mTOR-I died |
Søfteland et al. (2021) |
| mTOR-Ia | 6/53 (11.3%) | Immunosuppression was discontinued in patients required hospital admission | 5 admitted to hospital, 1 outpatient. No reported association between mTOR-I treatment and risk of developing ARDS or death | Bossini et al. (2020) |
| mTOR-Ia | 94/414 (22.7%) | Continued | 18 died, 76 recovered. No association between mTOR-I treatment and death | Crespo et al. (2020) |
| RAPA/EVE | 8/29 (27.6%) | Withdrawn | 7 patients discharged (2 developed AKI and 1 required ICU admission) 1 patient died |
Rodriguez-Cubillo et al. (2020) |
| EVE | 11/144 | In most cases reduced or discontinued | 6 survived, 5 nonsurvived | Cravedi et al. (2020) |
a
Drug not specified.