Oral antiviral therapy for treatment of COVID-19 in solid organ transplant recipients: Is the practice meeting the promise?

Solid organ transplant recipients (SOTRs) remain at high risk of progression to severe disease and hospitalization from Coronavirus disease 2019 (COVID-19). Regardless of vaccination status, burden of severe COVID-19 among SOTRs remains high and treatment of COVID-19 remains the main mitigating factor in preventing its progression. Oral antiviral therapies offer a convenient outpatient treatment option for mild-moderate COVID-19, and when used early may decrease the risk of progression of disease. Oral anti-viral therapies retain activity against all the currently known viral variants. Early diagnosis with prompt treatment and monitoring for drug-drug interactions is the key to optimal use of oral antiviral agents for COVID-19. Despite the promise to decrease morbidity and mortality from COVID-19, utilization of these medications among SOTRs remains low with existence of many barriers in their use.