Low Dose Indomethacin in the Outpatient Treatment of COVID-19 in Kidney Transplant Recipients—A Case Series

The pandemic caused by the coronavirus SARS-CoV-2 has affected millions of people around the world. There are no definitive treatments available to date, which has led to the use of several repurposed drugs. Indomethacin is an effective non-steroidal anti-inflammatory drug, which has played an important role in the treatment of rheumatological conditions and cytokine storms, in the past. Coronavirus disease 2019 (COVID-19) causes cytokine storm and multiorgan dysfunction resulting in high mortality in those affected. Kidney transplant recipients are susceptible to COVID-19, which has caused a higher mortality than the general population, due to the immunosuppressed state. Twelve kidney transplant recipients under regular follow up at our hospital, consulted over the telephone, if they had features of COVID-19. Low dose indomethacin in this group of patients was given in those who were assessed to have mild disease and could be managed at home. Four of twelve patients were admitted to hospital due to their worsening symptoms. However, none of them died and all the 12 patients made good recovery at the end of 4 weeks. This has resulted in not only treating their symptoms, but probably also prevented more hospitalizations by avoiding or attenuating a cytokine storm in them. Indomethacin could prove to be a useful drug in the treatment of mild COVID-19, in view of its easy availability, low cost and minimal side effects.