Safety and efficacy of nirmatrelvir and ritonavir in kidney transplant recipients with COVID-19

T-cell counts (OR = 0.982, 95% CI 0.968 - 0.998) as protective against ARDS, with an AUC of 0.859. Significant reductions in serum creatinine (p < 0.001) and aspartate aminotransferase (p = 0.01) were observed from admission to discharge, while alanine aminotransferase and estimated glomerular filtration rate (eGFR) remained stable. Complications were rare, occurring in only 2 patients. NR therapy demonstrated safety and effectiveness in KTRs, evidenced by improvements in renal and hepatic function as well as stable graft outcomes. CD4+ T-cell counts and albumin levels were identified as potential predictors of ARDS. These findings underscore the significance of early antiviral intervention and meticulous optimization of immunosuppressive management. However, further validation through larger multicenter prospective studies is necessary.