tetano
Editor, Senior Moderator
Int J Infect Dis
. 2026 Feb 2:108455.
doi: 10.1016/j.ijid.2026.108455. Online ahead of print.
Clinical outcomes of immunocompromised patients administered tixagevimab-cilgavimab as pre-exposure prophylaxis for COVID-19: real-world experience in Taiwan
Yu-Chien Ho[SUP] 1 [/SUP], Yi-Ting Wang[SUP] 2 [/SUP], Sheng-Hua Chou[SUP] 3 [/SUP], Szu- Yu Liu[SUP] 4 [/SUP], Chien Chuang[SUP] 5 [/SUP], Wan Chin[SUP] 4 [/SUP], Hsiang-Ling Ho[SUP] 6 [/SUP], Yi-Tsung Lin[SUP] 7 [/SUP]
Affiliations
Objectives: Immunocompromised patients with COVID-19 are at a higher risk of hospitalization and death. Low seroconversion rate after COVID-19 vaccination are common in immunocompromised patients. Evusheld, a combination of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies tixagevimab-cilgavimab, was previously recommended as COVID-19 pre-exposure prophylaxis for immunocompromised patients. Our study aimed to present the real-world experience of tixagevimab-cilgavimab use in Taiwan.
Methods: Adults who received tixagevimab-cilgavimab at the Taipei Veterans General Hospital during October 2022-June 2023 were identified. The main outcomes were SARS-CoV-2 infection, severe or critical COVID-19, and the 6-month all-cause mortality rate. Multivariate Cox regression analysis was performed to identify factors associated with poor outcomes.
Results: Overall, 352 adult patients received tixagevimab-cilgavimab. The common indications were hematological malignancies (84.1%), autoimmune disease (10.5%), solid organ transplantation (4.8%), and the presence of solid tumors under treatment (4.5%). During the 6-month follow-up, 39 patients (11.1%) test COVID-19 positive, including 29 (8.2%) and 10 (2.8%) who developed mild-to-moderate and severe or critical COVID-19, respectively. The overall 6-month all-cause mortality rate was 4.8%. In patients with COVID-19, the corresponding rate was 1.1%. Age ≥ 70 years (p = 0.038) and the presence of solid tumors under treatment (p = 0.033) were independent risk factors for severe or critical COVID-19.
Conclusions: Tixagevimab/cilgavimab -treated immunocompromised patients had a low rate of subsequent severe or critical COVID-19. Our study provides insights into the role of future monoclonal antibodies as COVID-19 pre-exposure prophylaxis among immunocompromised patients and emphasizes the need for ongoing research.
Keywords: COVID-19; Evusheld; SARS-CoV-2 monoclonal antibodies; tixagevimab and cilgavimab.
. 2026 Feb 2:108455.
doi: 10.1016/j.ijid.2026.108455. Online ahead of print.
Clinical outcomes of immunocompromised patients administered tixagevimab-cilgavimab as pre-exposure prophylaxis for COVID-19: real-world experience in Taiwan
Yu-Chien Ho[SUP] 1 [/SUP], Yi-Ting Wang[SUP] 2 [/SUP], Sheng-Hua Chou[SUP] 3 [/SUP], Szu- Yu Liu[SUP] 4 [/SUP], Chien Chuang[SUP] 5 [/SUP], Wan Chin[SUP] 4 [/SUP], Hsiang-Ling Ho[SUP] 6 [/SUP], Yi-Tsung Lin[SUP] 7 [/SUP]
Affiliations
- PMID: 41638347
- DOI: 10.1016/j.ijid.2026.108455
Objectives: Immunocompromised patients with COVID-19 are at a higher risk of hospitalization and death. Low seroconversion rate after COVID-19 vaccination are common in immunocompromised patients. Evusheld, a combination of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies tixagevimab-cilgavimab, was previously recommended as COVID-19 pre-exposure prophylaxis for immunocompromised patients. Our study aimed to present the real-world experience of tixagevimab-cilgavimab use in Taiwan.
Methods: Adults who received tixagevimab-cilgavimab at the Taipei Veterans General Hospital during October 2022-June 2023 were identified. The main outcomes were SARS-CoV-2 infection, severe or critical COVID-19, and the 6-month all-cause mortality rate. Multivariate Cox regression analysis was performed to identify factors associated with poor outcomes.
Results: Overall, 352 adult patients received tixagevimab-cilgavimab. The common indications were hematological malignancies (84.1%), autoimmune disease (10.5%), solid organ transplantation (4.8%), and the presence of solid tumors under treatment (4.5%). During the 6-month follow-up, 39 patients (11.1%) test COVID-19 positive, including 29 (8.2%) and 10 (2.8%) who developed mild-to-moderate and severe or critical COVID-19, respectively. The overall 6-month all-cause mortality rate was 4.8%. In patients with COVID-19, the corresponding rate was 1.1%. Age ≥ 70 years (p = 0.038) and the presence of solid tumors under treatment (p = 0.033) were independent risk factors for severe or critical COVID-19.
Conclusions: Tixagevimab/cilgavimab -treated immunocompromised patients had a low rate of subsequent severe or critical COVID-19. Our study provides insights into the role of future monoclonal antibodies as COVID-19 pre-exposure prophylaxis among immunocompromised patients and emphasizes the need for ongoing research.
Keywords: COVID-19; Evusheld; SARS-CoV-2 monoclonal antibodies; tixagevimab and cilgavimab.