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  • Severe COVID‐19 in a renal ...
    Meziyerh, Soufian; Zwart, Tom C.; Etten, Ronald W.; Janson, Jeroen A.; Gelder, Teun; Alwayn, Ian P. J.; Fijter, Johan W.; Reinders, Marlies E. J.; Moes, Dirk J. A. R.; Vries, Aiko P. J.

    American journal of transplantation, July 2020, Letnik: 20, Številka: 7
    Journal Article

    The current coronavirus disease 2019 (COVID‐19) pandemic requires extra attention for immunocompromised patients, including solid organ transplant recipients. We report on a case of a 35‐year‐old renal transplant recipient who suffered from a severe COVID‐19 pneumonia. The clinical course was complicated by extreme overexposure to the mammalian target of rapamycin inhibitor everolimus, following coadministration of chloroquine and lopinavir/ritonavir therapy. The case is illustrative for dilemmas that transplant professionals may face in the absence of evidence‐based COVID‐19 therapy and concurrent pressure for exploration of experimental pharmacological treatment options. However, the risk‐benefit balance of experimental or off‐label therapy may be weighed differently in organ transplant recipients than in otherwise healthy COVID‐19 patients, owing to their immunocompromised status and potential drug interactions with immunosuppressive therapy. With this case report, we aimed to achieve increased awareness and improved management of drug‐drug interactions associated with the various treatment options for COVID‐19 in renal transplant patients. This article reports on a case of coronavirus disease 2019 in a renal transplant recipient and aims to enhance awareness and provide guidance for the clinical management of drug interactions between immunosuppressive therapy and experimental or investigational antiviral agents.