Kidney Int Rep
. 2022 Mar 26.
doi: 10.1016/j.ekir.2022.03.020. Online ahead of print.
Early administration of Anti-SARS-CoV-2 Monoclonal Antibodies prevents severe Covid-19 in Kidney Transplant Patients
Juliette Gueguen 1 , Charlotte Colosio 2 , Arnaud Del Bello 3 , Anne Scemla 4 , Yohan N'Guyen 5 , Claire Rouzaud 6 , Claudia Carvalho-Schneider 7 , Gabriela Gautier Vargas 8 , Pierre Tremolières 9 , A Jalal Eddine 10 , Christophe Masset 11 , Olivier Thaunat 12 , Melchior Chabannes 13 , Paulo Malvezzi 14 , Pierre Pommerolle 15 , Lionel Couzi 16 , Nassim Kamar 3 , Sophie Caillard 8 , Philippe Gatault 1
Affiliations
- PMID: 35372734
- PMCID: PMC8957354
- DOI: 10.1016/j.ekir.2022.03.020
Abstract
Kidney transplant recipients (KTRs) are prone to develop severe coronavirus disease 2019 (Covid-19) and are less well protected by vaccine than immunocompetent subjects. Thus, the use of neutralizing monoclonal anti-SARS-CoV-2 antibody (MoAb) to confer a passive immunity appears attractive in KTRs.
Methods: We performed a French nation-wide study to compare Covid-19-related hospitalization, 30-days-admission to intensive care unit (ICU) and 30-days-death between KTRs who received an early infusion of MoAb (MoAb group) and KTRs who did not (control group). Controls were identified from the COVID-SFT registry (NCT04360707) using a propensity score matching with the following covariates: age, sex, delay between transplantation and infection, induction and maintenance immunosuppressive therapy, initial symptoms and comorbidities.
Results: Eighty KTRs received MoAb between February and June 2021. They were matched to 155 controls. Covid-19-related hospitalization, 30-days-admission to intensive care unit (ICU) and 30-days-death were less frequently observed in MoAb group (35.0% vs 49.7%, p=0.032; 2.5% vs 15.5%, p=0.002, 1.25% vs 11.6%, p=0.005, respectively). No patients required mechanical ventilation in MoAb group. The number of patients to treat to prevent one death was 9.7.
Conclusion: The early use of MoAb in KTRs with a mild form of Covid-19 largely improved outcomes in KTRs.
Keywords: BMI, body mass index; CNI, calcineurin inhibitor; COVID-19; Covid-19, coronavirus disease 2019; EMA, European Medicines Agency; FDA, Food and Drug Administration; HIV, human immunodeficiency virus; ICU, intensive care unit; IQR, interquartile range; KTR, kidney transplant recipient; MoAb, monoclonal antibody; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SOT, solid organ transplant; mTOR, mammalian target of rapamycin; monoclonal antibody; rt-PCR, real-time polymerase chain reaction; transplantation; viral infection.
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