ABSTRACT
Early use of anti-SARS-CoV-2 monoclonal antibodies has shown to be a safe option to reduce hospitalization and death in solid organ transplant recipients with COVID-19. Real world data regarding sotrovimab in heart transplant (HT) recipients is scarce. We aim to describe our experience in terms of safety and outcomes in this group. Consecutive HT recipients from our center with confirmed SARS-CoV-2 Omicron variant who received intravenous sotrovimab infusion between January and April 2022 were enrolled in this observational study. Clinical data was recorded including the first 24 hours post infusion, as well as 1-month and 3-month follow-ups. A total of 29 HT recipients with SARS-CoV-2 infection who received sotrovimab were enrolled [median age 53 (IQR 36, 62), 52% female]. Baseline characteristics are shown in Table 1. The median time since symptom onset was 2 (1,3) days, and 86% of patients had previously received ≥3 doses of COVID-19 vaccine. No acute infusion-related reactions were reported. A total of five patients were admitted (17%), 3 of them with COVID-19 pneumonitis, receiving high-dose steroids. Bacterial superinfection was reported in 4 patients. Neither invasive mechanical ventilation nor ICU care were required, and no in-hospital deaths were recorded. Hospitalized patients had more comorbidities [diabetes (40 vs 13%, p 0.13), hyperlipidemia (80 vs 29%, p 0.03), advanced chronic kidney disease (100 vs 38%, p 0.01), leucopenia (40 vs 4%, p 0.02), and anemia (100 vs 46%, 0.03)], compared to non-hospitalized patients. Over a median follow-up of 111 (86, 131) days, there were 2 cases of COVID-19 reinfection and 6 non-COVID-19-related readmissions. No episodes of acute rejection, new onset graft dysfunction or death were registered. In our series, the early use of sotrovimab in HT recipients with COVID-19 was safe. No COVID-19-related deaths were recorded, hospitalization rate was low and more frequent in patients with prior chronic comorbidities. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
As of April 2022, the Mater Hospital serves 190 patients who have been the recipient of a lung transplant in Ireland. During the COVID-19 pandemic, solid organ transplant was recognised as a risk factor for progression to severe disease. In January 2022, the European Medicines Agency (EMA) approved the use of Sotrovimab for high risk patients. Sotrovimab is a monoclonal antibody which neutralises SARS-CoV-2 with recent data showing efficacy in reducing the risk of progression to severe disease in high risk patients . We aim to describe our patient cohort and the rates of COVID-19 infection seen before and after the introduction of monoclonal antibody therapy. While likely reflecting emerging variants resulting in less severe disease, we observe variation in morbidity and mortality in this time. From March 2020 to April 2022, 116 post-lung transplant patients tested positive for COVID-19 infection. This represents 61% of our overall population. Since January 2022, coinciding with the surge of the omicron variant, 57 patients contracted COVID-19. 47 were deemed to be suitable for treatment with 10 presenting outside the window for therapeutic intervention. 3.5% (n=2) required ICU admission and 2 died directly as a result of COVID-19. Prior to this, 58 patients contracted COVID-19, 31 of which (53.5%) required hospital admission with 18 (58%) requiring ICU admission. Overall we saw 13 deaths representing 22.4% of this group and 6.8% of the overall population.