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Therapeutic management of COVID-19 in immunocompromised patients and interaction with the immune response: from preventive to curative strategies

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Since the SARS-CoV-2 breakthrough, immunocompromised patients are exposed to a higher risk of COVID-19-related complications and poor outcomes, including hospitalization, intensive care unit admission, and mortality. Even though the latter variants are less virulent, complications and mortality remain higher ...

Since the SARS-CoV-2 breakthrough, immunocompromised patients are exposed to a higher risk of COVID-19-related complications and poor outcomes, including hospitalization, intensive care unit admission, and mortality. Even though the latter variants are less virulent, complications and mortality remain higher in immunocompromised populations and COVID-19 is still an important concern for these patients. The efficacy of preventive strategies efficacy can depend on the variant type and may not last. Currently, preventive and curative management of COVID-19 in immunocompromised patients remains unclear.

Nirmatrelvir/ritonavir use exposes major drug-drug interaction with an important overdosing risk. Many management protocols have been published but data are still lacking. Moreover, nirmatrelvir/ritonavir and remdesivir are contraindicated in patients with chronic renal failure with an eGFR<30ml/min/1.73m², a common comorbidity in immunocompromised patients. In addition, curative monoclonal antibodies are currently lacking. Finally, the management of immunosuppressive therapy and its impact on the immune still unclear during COVID-19.

In this Research Topic, we welcome the submissions of Original Research, Reviews, Mini-Reviews, Methods, and Brief Research Reports focusing on, but not limited to the following subtopics:

1. New anti-SARS-CoV-2 vaccine strategies: clinical response and the impact on the immune system
2. Anti-SARS-CoV-2 monoclonal antibodies : interaction with SARS-CoV-2, immune response, viral immune pressure and escape
3. Impact of immunosuppressive therapy on COVID-19 outcome
4. Management of immunosuppressive therapy during COVID-19: impact on the immune system
5. Use of nirmatrelvir/ritonavir therapy under immunosuppressive therapy such as calcineurin inhibitors and/or mTOR inhibitors
6. Immunocompromised patients and optimal curative management of COVID-19
7. Immunocompromised patients and optimal preventive management of COVID-19

Keywords: COVID-19, Immunocompromised patients, therapeutic management


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