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SARS-CoV2 and immunosuppression: A double-edged sword.

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Transplant recipients may not face a higher risk of severe SARS-CoV-2 disease. This review explores immunosuppression

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Area of Science:

  • Infectious Diseases
  • Immunology
  • Transplantation Medicine

Background:

  • The severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic has profoundly affected global health.
  • The impact of SARS-CoV-2 on transplant recipients and immunosuppressed individuals remains under-explored, with conflicting data from prior coronavirus outbreaks.
  • Limited case reports suggest transplanted patients might not have a significantly increased risk of severe SARS-CoV-2 disease compared to the general population.

Purpose of the Study:

  • To review the existing literature on the impact of immunosuppression on coronavirus infections in transplant recipients.
  • To analyze the management of immunosuppression in SARS-CoV-2 infected transplant patients.
  • To provide a current overview of available data and considerations for clinicians managing immunocompromised patients during the pandemic.

Main Methods:

  • Conducted a comprehensive literature review.
  • Included case reports and series focusing on immunosuppression management in transplant recipients with coronavirus infections.
  • Specifically examined the roles of steroids, calcineurin inhibitors, and mycophenolic acid.

Main Results:

  • A limited number of cases have been reported, indicating potentially variable risk in transplanted populations.
  • Analysis of immunosuppressive agents like steroids, calcineurin inhibitors, and mycophenolic acid in the context of SARS-CoV-2 infection.
  • A snapshot of current literature provides insights into managing immunosuppression in this patient group.

Conclusions:

  • Transplant recipients' risk for severe SARS-CoV-2 disease requires further investigation, as current data is limited.
  • Understanding the interplay between immunosuppression and SARS-CoV-2 is crucial for clinical decision-making.
  • This review offers a timely resource for physicians caring for immunocompromised transplant patients during the ongoing pandemic.