Department of Clinical Pharmacy, Keck Hospital of USC, University of Southern California, Los Angeles, California, USA.
USC Transplant Institute, Keck Hospital of USC, University of Southern California, Los Angeles, California, USA.
Transpl Infect Dis. 2023 Aug;25(4):e14086. doi: 10.1111/tid.14086. Epub 2023 Jun 14.
Coronavirus disease 2019 (COVID-19) continues to negatively impact solid organ transplant recipients (SOTr). Data on the use of tixagevimab-cilgavimab (tix-cil) in vaccinated SOTr during circulation of Omicron and its subvariants are limited. Therefore, this single-center review was conducted to evaluate tix-cil efficacy in multiple organ transplant groups during a study period where Omicron B.1.1.529, BA.2.12.1, and BA.5 predominated.
In this single-center retrospective study, we evaluated the incidence of COVID-19 infection in adult SOTr who did or did not receive pre-exposure prophylaxis (PrEP) with tix-cil. SOTr were included if they were at least 18 years of age and met emergency use authorization criteria for tix-cil use. The primary outcome analyzed was the incidence of COVID-19 infection.
Ninety SOTr met inclusion criteria and comprised of two groups, tix-cil PrEP (n = 45) and no tix-cil PrEP (n = 45). Of SOTr who received tix-cil PrEP, three (6.7%) developed COVID-19 infection, compared to eight (17.8%) in the no tix-cil PrEP group (p = .20). Of the 11 SOTr diagnosed with COVID-19, 15 (82.2%) were fully vaccinated against COVID-19 prior to transplantation. Moreover, 18.2% and 81.8% of the COVID-19 cases observed were asymptomatic and mild-to-moderate, respectively.
Our study results, which included months when BA.5 was in increased circulation, suggest no significant difference in COVID-19 infection with or without use of tix-cil PrEP in our solid organ transplant groups. As the COVID-19 pandemic continues to evolve, clinical utility of tix-cil should be evaluated against new, emerging strains.
2019 年冠状病毒病（COVID-19）继续对实体器官移植受者（SOTr）产生负面影响。关于在 Omicron 及其亚变体流行期间接种疫苗的 SOTr 使用替卡瑞韦单抗-西加韦单抗（tix-cil）的数据有限。因此，进行了这项单中心回顾性研究，以评估在 Omicron B.1.1.529、BA.2.12.1 和 BA.5 占主导地位的研究期间，多种器官移植组中 tix-cil 的疗效。
在这项单中心回顾性研究中，我们评估了接受或未接受替卡瑞韦单抗-西加韦单抗（tix-cil）暴露前预防（PrEP）的成年 SOTr 中 COVID-19 感染的发生率。如果 SOTr 年龄至少为 18 岁且符合替卡瑞韦单抗使用紧急使用授权标准，则纳入研究。分析的主要结局是 COVID-19 感染的发生率。
90 名 SOTr 符合纳入标准，分为替卡瑞韦单抗-西加韦单抗 PrEP 组（n = 45）和无替卡瑞韦单抗-西加韦单抗 PrEP 组（n = 45）。接受替卡瑞韦单抗-西加韦单抗 PrEP 的 SOTr 中，有 3 名（6.7%）发生 COVID-19 感染，而无替卡瑞韦单抗-西加韦单抗 PrEP 组中则有 8 名（17.8%）（p =.20）。在诊断为 COVID-19 的 11 名 SOTr 中，有 15 名（82.2%）在移植前已完全接种 COVID-19 疫苗。此外，观察到的 COVID-19 病例中，无症状和轻度至中度分别占 18.2%和 81.8%。
我们的研究结果包括 BA.5 传播增加的月份，表明在我们的实体器官移植组中，使用或不使用替卡瑞韦单抗-西加韦单抗 PrEP 预防 COVID-19 感染没有显著差异。随着 COVID-19 大流行的持续演变，应评估替卡瑞韦单抗的临床应用价值，以应对新出现的、不断出现的变异株。
