Transpl Immunol . The efficacy of neutralizing monoclonal antibodies in transplant recipients with mild-to-moderate COVID-19

[tetano]

Transpl Immunol


. 2022 Dec 27;101777.
doi: 10.1016/j.trim.2022.101777. Online ahead of print.
The efficacy of neutralizing monoclonal antibodies in transplant recipients with mild-to-moderate COVID-19


Ken Arimura ¹ , Etsuko Tagaya ² , Ken Kikuchi ³ , Toshihiro Mitsuda ⁴ , Fumiya Ebihara ⁵ , Takumi Maruyama ⁵ , Yukihiro Hamada ⁵ , Kohei Unagami ⁶ , Taichi Kanzawa ⁶ , Haruki Sekiguchi ⁷ , Ken Shimamoto ⁷ , Hideki Ishida ⁶ , Hiroto Egawa ⁸ , Junji Tanaka ⁹ , Masatoshi Kawana ⁷



Affiliations

• PMID: 36584927
• PMCID: PMC9796351
• DOI: 10.1016/j.trim.2022.101777

Free PMC article

Abstract

Introduction: Transplant recipients (TRs) are at high risk for severe coronavirus disease 2019 (COVID-19). Neutralizing monoclonal antibodies (mAbs) are used for treating mild-to-moderate COVID-19. However, reports comparing the efficacy of COVID-19 treatment without/with mAbs in TRs are limited. We assessed the efficacy of casirivimab/imdevimab against mild-to-moderate COVID-19 in TRs.
Methods: Forty-one patients were retrospectively evaluated. The duration until defervescence, oxygen (O₂) requirement ≥5 L, and neutralizing antibody levels were compared in TRs with COVID-19 without/with casirivimab/imdevimab.
Results: Casirivimab/imdevimab was correlated with shorter duration until defervescence and non-requirement of O₂ ≥ 5 L in TRs with COVID-19 [mean: without/with: 6 vs. 2; P = 0.0002, hazard ratio (HR) = 0.3333, 95% confidence interval (CI) = 0.1763-0.6301; 15 vs. 8; P < 0.0001, HR = 0.5333, 95% CI = 0.2878-0.9883; P = 0.0377, HR = 0.1502, 95% CI = 0.02511-0.8980]. Casirivimab/imdevimab was associated with early defervescence after adjusting for sex and age (P = 0.013, HR = 0.412, 95% CI = 0.205-0.826). The antibody levels between patients without/with casirivimab/imdevimab on the day of hospitalization were not significantly different (P = 0.1055), including 13 TRs with vaccination. Antibody levels were higher in patients with casirivimab/imdevimab at 3-5 days after hospitalization than in those without, at 7-9 days after hospitalization (P < 0.0001, mean, without/with: 414.9/40000 AU/mL).
Conclusion: Casirivimab/imdevimab was effective and increased the neutralizing antibody in TRs with mild-to-moderate COVID-19, it may contribute toward preventing the progression.

Keywords: COVID-19; Casirivimab/imdevimab; Neutralizing antibody; SARS-CoV-2; TRs.