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Transpl Int . Monoclonal Antibodies in Prevention and Early Treatment of COVID-19 in Lung Transplant Recipients: A Systematic Review and Perspectiv

tetano

Editor, Senior Moderator
Transpl Int


. 2025 Feb 10:38:13800.
doi: 10.3389/ti.2025.13800. eCollection 2025. Monoclonal Antibodies in Prevention and Early Treatment of COVID-19 in Lung Transplant Recipients: A Systematic Review and Perspective on the Role of Monoclonal Antibodies in the Future

David A Van Eijndhoven[SUP] 1 [/SUP], Robin Vos[SUP] 2 3 [/SUP], Saskia Bos[SUP] 2 3 [/SUP]



Affiliations
Abstract

Coronavirus disease 2019 (COVID-19) has significantly impacted lung transplant recipients (LTR), who remain vulnerable to severe COVID-19 despite vaccination, prompting the use of monoclonal antibodies (mAbs) as a treatment option. This systematic review summarizes the clinical efficacy of mAbs against COVID-19 in adult LTR and provides a perspective on the role of mAbs for infectious diseases in the future. A systematic search of PubMed/MEDLINE, Embase and Cochrane was conducted for studies reporting clinical outcomes of adult LTR or solid organ transplant recipients (SOTR) including LTR with drug-specific outcomes. Twelve studies were included. Pre-exposure prophylaxis with mAbs reduced COVID-19 breakthrough infection in LTR. Early treatment of COVID-19 with mAbs correlated with a reduced incidence of severe COVID-19 outcomes, although statistical significance varied among studies. Overall, observational studies have demonstrated a potential benefit of mAbs in the treatment of COVID-19 in LTR, both in prophylaxis and early treatment, as well as the importance of early administration. Moreover, mAb therapy appeared safe and could be a viable option against other pathogens, a route that warrants further investigation.
Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382133, identifier CRD42022382133.

Keywords: COVID-19; Sars-CoV-2; bamlanivimab; casirivimab/imdevimab; lung transplantation; monoclonal antibodies; sotrovimab; tixagevimab/cilgavimab.

 
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