Early administration of anti-SARS-CoV-2 monoclonal antibodies prevents severe Covid-19 in kidney transplant patients

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Kidney Int Rep. 2022 Mar 26. doi:10.1016/j.ekir.2022.03.020. Online ahead of print.

ABSTRACT

Kidney transplant recipients (KTR) are susceptible to developing severe coronavirus disease 2019 (Covid-19) and are less well protected by the vaccine than immunocompetent subjects. Thus, the use of anti-SARS-CoV-2 neutralizing monoclonal antibodies (MoAb) to confer passive immunity seems interesting in KTRs.

Methods: We performed a French national study to compare Covid-19-related hospitalization, 30-day intensive care unit (ICU) admission, and 30-day death between KTRs who received an early infusion of MoAb (MoAb group) and KTRs that did not (control group). Controls were identified from the COVID-SFT registry (NCT04360707) using a propensity score corresponding to the following covariates: age, sex, time between transplantation and infection, immunosuppressive induction and d interview, initial symptoms and comorbidities.

RESULTS: Eighty KTRs received MoAb between February and June 2021. They were matched to 155 controls. Covid-19 hospitalizations, 30-day intensive care unit (ICU) admissions, and 30-day deaths were observed less frequently in the MoAb group (35.0% vs. 49.7%, p=0.032 2.5% versus 15.5%, p=0.002, 1.25% versus 11.6%, p=0.005, respectively). No patient required mechanical ventilation in the MoAb group. The number needed to treat to prevent one death was 9.7.

CONCLUSION: Early use of MoAb in KTRs with a mild form of Covid-19 greatly improved outcomes in KTRs.

PMID:35372734 | PMC: PMC8957354 | DOI:10.1016/j.ekir.2022.03.020

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