**1. Introduction**

Coronavirus disease 2019 (COVID-19) has an increased incidence and risk of severe infection among immunocompromised patients [1]. Transplant patients are also known to frequently have delayed clearance or prolonged shedding of respiratory viruses [2]. With this in mind, therapy that may reduce the severity and/or duration of illness are crucial. Currently, remdesivir is the only FDA approved anti-viral drug for COVID-19 although the evidence supporting its benefit is uncertain based upon published trials [3]. Recently it has been suggested that cycle threshold values (Ct) obtained on polymerase chain reaction (PCR) tests may serve as a marker of disease severity with lower values (i.e., higher viral load) being associated with higher mortality [4]. Similarly, reduction in SARS-CoV-2 viral load with treatment is now considered a valid surrogate marker of treatment efficacy [5]. This letter describes our center's experience with using remdesivir and/or reduced anti-metabolite dosing in an attempt to expedite clearance of the virus, as indirectly measured by serial PCR Ct testing. Patients with severe leukopenia (WBC < 3.0) were treated with elimination of anti-metabolite while the remainder received a 50% reduction in anti-metabolite dose [6].

**Citation:** Winstead, R.J.; Christensen, J.; Sterling, S.; Morales, M.; Kumar, D.; Bryson, A.; Gupta, G. Effect of Remdesivir on COVID-19 PCR Positivity and Cycle Threshold in Kidney Transplant Recipients. *Transplantology* **2021**, *2*, 291–293. https://doi.org/10.3390/ transplantology2030028

Academic Editors: Macé M. Schuurmans and René Hage

Received: 26 July 2021 Accepted: 16 August 2021 Published: 18 August 2021

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