Early Administration of Anti–SARS-CoV-2 Monoclonal Antibodies Prevents Severe COVID-19 in Kidney Transplant Patients

Gueguen, Juliette; Colosio, Charlotte; Bello, Arnaud Del; Scemla, Anne; Nguyen, Yohan; Rouzaud, Claire; Carvalho-Schneider, Claudia; Gautier-Vargas, Gabriela; Tremolières, Pierre; Eddine, A. Jalal; Masset, Christophe; Thaunat, Olivier; Chabannes, Melchior; Malvezzi, Paulo; Pommerolle, Pierre; Couzi, Lionel; Kamar, Nassim; Caillard, Sophie; Gatault, Philippe

doi:10.1016/j.ekir.2022.03.020

Cited by 27 publications

(19 citation statements)

References 36 publications

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“…The mAb group had less frequent hospitalizations (35% versus 49.7%, P = 0.032), ICU admissions (2.5% versus 15.5%, P = 0.002), and deaths (1.25% versus 11.6%, P = 0.005), and no patient in the mAb group required mechanical ventilation. 43 Although not a randomized trial, this study provided evidence that SOT recipients do benefit from early treatment with mAb, to prevent progression to severe disease.…”

Section: Sars-cov-2 Monoclonal Antibodies For Treatmentmentioning

confidence: 92%

“…And if historical controls are chosen (eg, before the availability of mAbs), this introduces the problem of changing management between different eras, and sometimes different viral variants. To address this issue, Gueguen et al 43 performed a propensity-matched study of 80 kidney transplant recipients who received mAbs for early COVID between February 2021 and May 2021, in terms of hospitalizations, ICU admissions, and mortality within 30 d. These patients were treated with bamlanivimab, bamlanivimab-etesevimab, or casirivimab-imdevimab, and were compared with 155 propensity-matched controls with covariates of age, sex, time since transplant, immunosuppressive therapy, initial symptoms, and comorbidities. The mAb group had less frequent hospitalizations (35% versus 49.7%, P = 0.032), ICU admissions (2.5% versus 15.5%, P = 0.002), and deaths (1.25% versus 11.6%, P = 0.005), and no patient in the mAb group required mechanical ventilation.…”

Section: Sars-cov-2 Monoclonal Antibodies For Treatmentmentioning

confidence: 99%

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Update on COVID-19 Therapeutics for Solid Organ Transplant Recipients, Including the Omicron Surge

Avery

2022

Transplantation

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Major changes have occurred in therapeutics for coronavirus-19 (COVID-19) infection over the past 12–18 mo, most notably in early outpatient therapy. In most cases, solid organ transplant recipients were not included in the original clinical trials of these agents, so studies of real-world outcomes have been important in building our understanding of their utility. This review examines what is known about clinical outcomes in solid organ transplant recipients with newer therapies. SARS-CoV-2 monoclonal antibodies for early treatment or prophylaxis have likely prevented many hospitalizations and deaths. In addition, convalescent plasma, the oral drugs nirmatrelvir/ritonavir and molnupiravir, remdesivir for early outpatient treatment, anti-inflammatory therapy, and investigational virus-specific T-cell therapy will be discussed. Finally, the later consequences of COVID-19, such as secondary infections, long COVID symptoms, and persistent active infection, are identified as areas for future research.

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Section: Sars-cov-2 Monoclonal Antibodies For Treatmentmentioning

confidence: 92%

Section: Sars-cov-2 Monoclonal Antibodies For Treatmentmentioning

confidence: 99%

Update on COVID-19 Therapeutics for Solid Organ Transplant Recipients, Including the Omicron Surge

Avery

2022

Transplantation

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“…from the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seems to be less severe in general population in comparison with the previous variants of concern. 1 However, in kidney transplant recipients (KTRs), Omicron continues to be a considerable threat 2 due to immunosuppression status and blunt response to vaccination. 3 Clinical trials with remdesivir have demonstrated improved time to recovery in patients on oxygen with coronavirus disease 2019 (COVID-19).…”

mentioning

confidence: 99%

Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection

Cacho

Nicolás

Bodro

et al. 2022

Kidney International

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“…These include the following measures: (1) Increase the vaccination rate of the general population; 2 (2) Develop vaccines and/or anti-SARS-CoV-2 immunoglobulins against emerging and potential variants; 58-62 (3) Administer booster vaccines for non-responders; 63-64 (4) Accelerate clinical trials of intranasal SARS-CoV-2 vaccines to prevent transmission; 65 (5) Assessment of humoral immune response of children, the elderly, and immunocompromised persons within 1-3 months after vaccine booster shot; 45,[66][67][68][69][70][71] and (6) Incorporate additional protective measures for individuals with persistent (a fourth or fifth dose) negative humoral immune response after booster vaccination, such as injection of anti-SARS-CoV-2 immunoglobulins, antiviral drug treatment, usage of N95 masks in endemic areas, etc. [41][42][43][72][73][74][75][76][77]…”

Section: Discussionmentioning

confidence: 99%

Immunological findings in a group of individuals who were non-responders to standard two-dose SARS-CoV-2 vaccines

Zeng

Yang

Qi³

et al. 2022

Preprint

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Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic. The virus has infected more than 505 million people and caused more than 6 million deaths. However, data on non-responders to SARS-CoV-2 vaccines in the general population are limited. The objective of the study is to comprehensively compare the immunological characteristics of non-responders to SARS-CoV-2 vaccines in the 18-59 years with that in the 60 years and older using internationally recognized cutoff values. Participants included 627 individuals who received physical examinations and volunteered to participate in COVID-19 vaccination from the general population. The main outcome was an effective seroconversion characterized by anti-SARS-CoV-2 spike IgG level of at least 4-fold increase from baseline. Profiling of naive immune cells was analyzed prior to vaccination to demonstrate baseline immunity. Outcomes of effective seroconversion in the 18-59 years with that in the 60 years and older were compared. The quantitative level of the anti-spike IgG was significantly lower in the 60 years and older and in men among the 18-59 years. There were 7.5% of non-responders among the 18-59 years and 11.7% of non-responders in the 60 years and older using the 4-fold increase parameter. The effective seroconversion rate was significantly related to the level of certain immune cells before vaccination, such as CD4 cells, CD8 cells and B cells and the age. An individual with a titer of anti-SARS-CoV-2 spike IgG that is below 50 BAU/mL might be considered a non-responder between 14-90 days after the last vaccine dose. Booster vaccination or additional protective measures should be recommended for non-responders as soon as possible to reduce disease severity and mortality.

show abstract

Early Administration of Anti–SARS-CoV-2 Monoclonal Antibodies Prevents Severe COVID-19 in Kidney Transplant Patients

Cited by 27 publications

References 36 publications

Update on COVID-19 Therapeutics for Solid Organ Transplant Recipients, Including the Omicron Surge

Update on COVID-19 Therapeutics for Solid Organ Transplant Recipients, Including the Omicron Surge

Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection

Immunological findings in a group of individuals who were non-responders to standard two-dose SARS-CoV-2 vaccines

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