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Kidney Int Rep . Early administration of Anti-SARS-CoV-2 Monoclonal Antibodies prevents severe Covid-19 in Kidney Transplant Patients

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Charlotte Colosio[SUP] 2 [/SUP], Arnaud Del Bello[SUP] 3 [/SUP], Anne Scemla[SUP] 4 [/SUP], Yohan N'Guyen[SUP] 5 [/SUP], Claire Rouzaud[SUP] 6 [/SUP], Claudia Carvalho-Schneider[SUP] 7 [/SUP], Gabriela Gautier Vargas[SUP] 8 [/SUP], Pierre Tremolières[SUP] 9 [/SUP], A Jalal Eddine[SUP] 10 [/SUP], Christophe Masset[SUP] 11 [/SUP], Olivier Thaunat[SUP] 12 [/SUP], Melchior Chabannes[SUP] 13 [/SUP], Paulo Malvezzi[SUP] 14 [/SUP], Pierre Pommerolle[SUP] 15 [/SUP], Lionel Couzi[SUP] 16 [/SUP], Nassim Kamar[SUP] 3 [/SUP], Sophie Caillard[SUP] 8 [/SUP], Philippe Gatault[SUP] 1 [/SUP]



Affiliations

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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