Immunosuppressant Management in Renal Transplant Patients with COVID-19

Table 1

Immunosuppressants, their mode of action and immunological outcomes in COVID-19.

Immunosuppressant class	Examples	Mode of action	Immunological outcomes in COVID-19	Reference
Corticosteroids	Dexamethasone, prednisone	Inhibition of lymphocyte gene expression	Suppressing cytokine storm prohibition of proinflammatory cytokine production, preserving the permeability and integrity of endothelium	[74]
Antimetabolites	Mycophenolic acid, azathioprine	Blocking DNA replication	Diminished immune response in vitro	[75]
Calcinurine inhibitors	Cyclosporine, tacrolimus	Inhibition of lymphocyte signalling	Selective inhibition of cytokine production and function	[57]
mTOR inhibitors	Sirolimus, everolimus	Inhibition of mammalian target of rapamycin (mTOR)	Inducing and cell cycle arrest in lymphocytes	[76]
Biologics	IL-2 inhibitors (daclizumab), IL-6 inhibitors(tocilizumab)	Act as anticytokine antibodies	Inhibiting the production of cytokines and thus alleviation of cytokine storm	[77]