COVID-19 Therapeutics for Solid Organ Transplant Recipients; 6 Months Into the Pandemic: Where Are We Now?

As in the general population with coronavirus 2019 (COVID-19) infection, therapeutic interventions in solid organ transplant (SOT) recipients have evolved over time. The preceding 6 months of the pandemic can be divided into 2 main therapeutic eras: the early era and the later era. The first era was characterized by the widespread use of drugs such as hydroxychloroquine with or without azithromycin, lopinavir-ritonavir, and tocilizumab. More recently, with the publication of larger trials, there has been increasing use of remdesivir, dexamethasone, and convalescent plasma, with the rapid proliferation of clinical trials including a wide variety of investigational and repurposed agents with antiviral or immunomodulatory effects. This overview focuses on what is known about the effects of different therapies in SOT recipients with COVID-19, mainly from case series and, more recently, larger multicenter registries; as well as outlining the information that will be needed to optimize management and outcomes in SOT recipients with COVID-19 in the future.