Treatment with sotrovimab for SARS-CoV-2 infection in a cohort of high-risk kidney transplant recipients.

Background: Sotrovimab is a neutralizing monoclonal antibody (mAb) that seems to remain active against recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. The evidence on its use in kidney transplant (KT) recipients, however, is limited. Methods: We performed a multicenter, retrospective cohort study of 82 KT patients with SARS-CoV-2 infection {coronavirus disease 2019 [COVID-19]} treated with sotrovimab. Results: Median age was 63 years. Diabetes was present in 43.9% of patients, and obesity in 32.9% of patients; 48.8% of patients had an estimated glomerular filtration rate under 30 mL/minute/1.73 m2. Additional anti-COVID-19 therapies were administered to 56 patients, especially intravenous steroids (65.9%). Sotrovimab was administered early (<5 days from the onset of the symptoms) in 46 patients (56%). Early-treated patients showed less likely progression to severe COVID-19 than those treated later, represented as a lower need for ventilator support (2.2% vs 36.1%; P < .001) or intensive care admission (2.2% vs 25%; P = .002) and COVID-19-related mortality (2.2% vs 16.7%; P = .020). In the multivariable analysis, controlling for baseline risk factors to severe COVID-19 in KT recipients, early use of sotrovimab remained as a protective factor for a composite outcome, including need for ventilator support, intensive care, and COVID-19-related mortality. No anaphylactic reactions, acute rejection episodes, impaired kidney function events, or non-kidney side effects related to sotrovimab were observed. Conclusions: Sotrovimab had an excellent safety profile, even in high-comorbidity patients and advanced chronic kidney disease stages. Earlier administration could prevent progression to severe disease, while clinical outcomes were poor in patients treated later. Larger controlled studies enrolling KT recipients are warranted to elucidate the true efficacy of monoclonal antibody therapies.

Direct-Acting Antiretroviral Therapy in Renal Transplant Recipients With Human Immunodeficiency Virus-Hepatitis C Virus Coinfection: Report of Our Experience and Literature Review.

A minor graft and patient survival are described in renal transplant recipients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) coinfection than in recipients infected with only HIV. The high efficacy of direct-acting antivirals could improve the results. The experience reported in renal transplant recipients with coinfection is very limited. MATERIAL AND METHODS: We analyzed the evolution of renal recipients with HIV-HCV coinfection treated with direct-acting antivirals in our center. Clinical, analytical, and microbiological variables were collected before and after treatment. RESULTS: From 2001 to 2018 we performed 11 renal transplants in patients with HIV infection, and 6 (54.5%) had HIV-HCV coinfection. One patient lost the graft before the development of direct-acting antivirals. Another patient with functioning graft has refused to receive any treatment. Four patients have been treated with direct-acting antivirals. One was treated 18 months before the transplant; 3 received treatment after transplant. All received sofosbuvir-based therapies. All had a sustained virologic response after 12 weeks and an improvement of liver function. In the patients treated after renal transplant, time post transplant at the beginning of treatment was 99.6 (SD, 22.8) months, and follow-up after treatment in all patients was 40.2 (SD, 8.16) months. To modify immunosuppressive regimen was not necessary, although 2 patients required an increase of tacrolimus doses. We do not observe deterioration of renal function. All have maintained a good immunologic and microbiological control without requiring changes in antiretrovirals. We do not observe complications associated with treatment. CONCLUSIONS: Direct-acting antivirals therapy is safe and effective and may offer new possibilities to patients with HIV-HCV coinfection.

Competencia social y pragmática en el alumnado inmigrante / No disponible

El estudio analiza la relación existente entre la competencia pragmática y la competencia social del alumnado inmigrante en la etapa de Educación Primaria, diferenciando entre aspectos facilitadores (liderazgo, jovialidad, sensibilidad social y respeto-autocontrol) y perturbadores/inhibidores (agresividad-terquedad, apatía-retraimiento y ansiedad-timidez) de la socialización. La muestra está compuesta por un total de 326 alumnos de origen inmigrante, de edades comprendidas entre los 6 y los 12 años escolarizados en colegios públicos. El instrumento utilizado para evaluar la socialización de los escolares, es la versión para profesores de la Batería de Socialización (BAS) y utilizamos la versión Screening Revisada de la Batería de Lenguaje Objetiva y Criterial (BLOCSR) para evaluar la competencia pragmática. Los resultados ponen de manifiesto la relación existente entre la competencia pragmática y las dimensiones facilitadoras y perturbadoras de la socialización en el alumnado inmigrante, señalando que los alumnos que dominan la competencia pragmática, muestran altas puntuaciones en liderazgo y a su vez puntúan menos en ansiedad-timidez

The study analyzes the relationship between pragmatic competence and social competence of immigrant students in Primary Education, differentiating between facilitators aspects (leadership, joviality, social sensibility, self-respect) and disruptive / inhibitors (aggressiveness, obstinacy, apathy -withdrawal and anxiety-shyness) socialization. The sample is made up of a total of 326 immigrant students, aged between 6 and 12 years enrolled in public schools. The instrument used to evaluate the socialization of school students is the version for teachers of the Socialization Test (BAS) and we used the Revised Screening version of the Objective Language Criteria Test (BLOC-SR) to evaluate the children’s pragmatic competence. The results show the relationship between pragmatic competence and enabling and disruptive dimensions of socialization in immigrant students, indicating that students who master the pragmatic competence, show high scores in leadership and in turn scored less anxiety-shyness