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SARS-CoV-2 Neutralizing Monoclonal Antibodies for the Treatment of COVID-19 in Kidney Transplant Recipients.
Wang, Aileen X; Busque, Stephan; Kuo, Jamie; Singh, Upinder; Röeltgen, Katharina; Pinsky, Benjamin A; Chertow, Glenn M; Scandling, John D; Lenihan, Colin R.
  • Wang AX; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California.
  • Busque S; Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California.
  • Kuo J; Pharmacy Manager of Clinical Effectiveness, Department of Pharmacy, Stanford Health Care, Stanford, California.
  • Singh U; Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
  • Röeltgen K; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California.
  • Pinsky BA; Department of Pathology, Stanford University School of Medicine, Stanford, California.
  • Chertow GM; Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
  • Scandling JD; Department of Pathology, Stanford University School of Medicine, Stanford, California.
  • Lenihan CR; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Kidney360 ; 3(1): 133-143, 2022 01 27.
Article in English | MEDLINE | ID: covidwho-1776876
ABSTRACT

Background:

Morbidity and mortality associated with coronavirus disease 2019 (COVID-19) infection in kidney transplant recipients are high and early outpatient interventions to prevent progression to severe disease are needed. SARS-CoV-2 neutralizing mAbs, including bamlanivimab and casirivimab-imdevimab, received emergency use authorization in the United States in November 2020 for treatment of mild to moderate COVID-19 disease.

Methods:

We performed a retrospective analysis of 27 kidney transplant recipients diagnosed with COVID-19 between July 2020 and February 2021 who were treated with bamlanivimab or casirivimab-imdevimab and immunosuppression reduction. We additionally identified 13 kidney transplant recipients with COVID-19 who had mild to moderate disease at presentation, who did not receive mAbs, and had SARS-CoV-2 serology testing available.

Results:

There were no deaths or graft failures in either group. Both infusions were well tolerated. Four of the 27 patients treated with mAbs required hospitalization due to COVID-19. Four of 13 patients who did not receive mAbs required hospitalization due to COVID-19. Patients who received mAbs demonstrated measurable anti-SARS-CoV-2 IgG with angiotensin-converting enzyme 2 (ACE2) receptor blocking activity at the highest level detectable at 90 days postinfusion, whereas ACE2 blocking activity acquired from natural immunity in the mAb-untreated group was weak.

Conclusions:

Bamlanivimab and casirivimab-imdevimab combined with immunosuppression reduction were well tolerated and associated with favorable clinical outcomes in kidney transplant recipients diagnosed with mild to moderate COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Kidney360 Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Kidney Transplantation / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Kidney360 Year: 2022 Document Type: Article