Tixagevimab/Cilgavimab as SARS-CoV-2 Pre-Exposure Prophylaxis in Lung Transplant Recipients during the Omicron Wave: A Real-World Monocentric Experience.

Publication date: Jul 15, 2024

Lung transplant recipients (LTRs) respond poorly to vaccination. SARS-CoV-2 pre-exposure prophylaxis (PrEP) with tixagevimab/cilgavimab (TIX/CIL) reduces the incidence of infection and the evolution to severe COVID-19. In vitro data show decreased activity against Omicron variants. We evaluated the clinical efficacy and safety of TIX/CIL in LTRs during the Omicron wave. A prospective observational cohort study was conducted at ISMETT in Palermo (Italy). In June 2022, SARS-CoV-2 PrEP with TIX/CIL 150/150 mg was offered to LTRs. LTRs who received TIX/CIL were compared to LTRs who did not. Logistic regression analysis (adjusted for prior COVID-19, SARS-CoV-2 vaccination, age, years from transplant, and rejection) was performed. The objective of this study was to compare the following among the two populations: prevalence of SARS-CoV-2, length of SARS-CoV-2 positivity, and COVID-19 disease severity. Among 110 eligible LTRs, 79 (72%) received TIX/CIL and 31 (28%) did not. SARS-CoV-2 infections occurred in 6% (n = 5) of patients who received TIX/CIL and 29% (n = 9) of patients who did not (p < 0. 001). In both groups, infections were mild/asymptomatic, and no one was hospitalized or died. At multivariate analysis, TIX/CIL was associated with a lower risk of infection (aOR 0. 22; 95%CI 0. 06-0. 78; p = 0. 02). TIX/CIL was safe and effective in reducing the risk of SARS-CoV-2 in LTRs during the Omicron wave.

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Concepts	Keywords
Italy	COVID-19
June	lung transplantation
Poorly	SARS-CoV-2 pre-exposure prophylaxis
Transplant	tixagevimab/cilgavimab

Semantics

Type	Source	Name
disease	VO	vaccination
disease	MESH	infection
disease	MESH	COVID-19
disease	VO	effective
disease	MESH	Infectious Diseases
drug	DRUGBANK	Coenzyme M
disease	VO	USA
disease	VO	organ
disease	MESH	asymptomatic infection
disease	IDO	immunosuppression
disease	MESH	immunocompromised hosts
disease	VO	unvaccinated
disease	VO	vaccinated
disease	VO	vaccine
disease	VO	passive immunization
disease	MESH	breakthrough infection
disease	MESH	hematological malignancies
disease	IDO	cell
disease	VO	population
disease	VO	Glycoprotein
drug	DRUGBANK	Angiotensin II
disease	IDO	host
disease	MESH	emergency
disease	IDO	susceptibility
disease	VO	frequency
drug	DRUGBANK	Aspartame
disease	MESH	thrombocytopenia
drug	DRUGBANK	Pentaerythritol tetranitrate
disease	MESH	death
disease	MESH	morbidities
disease	MESH	cardiovascular diseases
disease	MESH	chronic obstructive pulmonary disease
disease	MESH	liver diseases
disease	MESH	malignancy
disease	MESH	HIV infection
disease	MESH	AIDS
disease	MESH	rheumatic diseases
disease	MESH	comorbidity
disease	IDO	history
disease	MESH	sore throat
disease	MESH	respiratory failure
drug	DRUGBANK	Oxygen
drug	DRUGBANK	Methylprednisolone
drug	DRUGBANK	Basiliximab
drug	DRUGBANK	Tacrolimus
drug	DRUGBANK	Mycophenolic acid
drug	DRUGBANK	Prednisone
disease	VO	protocol
disease	VO	age

Original Article

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