Current and Emerging Therapies for COVID-19 in Lung Transplantation

Curr Pulmonol Rep. 2023;12(2):23-35. doi: 10.1007/s13665-023-00302-3. Epub 2023 Feb 16.

Abstract

Purpose of review: The landscape of the coronavirus disease 2019 (COVID-19) pandemic has rapidly changed over the past 3 years. Paralleling this evolution, the scientific and medical communities have reported many novel findings relating to the infection's epidemiology, transmission, diagnosis, and treatment. We review pertinent studies of COVID-19 therapeutics with an emphasis on their application to lung transplant recipients.

Recent findings: Agents that have been well-studied for treating COVID-19 include antivirals (remdesivir, nirmatrelvir/ritonavir, molnupiravir), monoclonal antibodies, and immunomodulators (for example, corticosteroids and tocilizumab).

Summary: Remdesivir remains an essential therapy for managing mild-moderate COVID-19. Though highly efficacious for mild-moderate COVID-19 for outpatient therapy, ritonavir-boosted nirmatrelvir has limited use in lung transplant recipients due to significant drug-drug interactions. Monoclonal antibodies, though useful, are the most affected by the emergence of new viral variants.

Keywords: COVID-19; Lung transplant; Molnupiravir; Monoclonal antibodies; Nirmatrelvir; Remdesivir.

Publication types

  • Review