Treatment with sotrovimab for SARS-CoV-2 infection in a cohort of high-risk kidney transplant recipients
Por:
Villanego, F, Mazuecos, A, Cubillo, B, Merino, M, Poveda, I, Saura, I, Segurado, O, Cruzado, L, Eady, M, Zarraga, S, Aladren, M, Cabello, S, Lopez, V, Gonzalez, E, Lorenzo, I, Espi-Reig, J, Fernandez, C, Osma, J, Ruiz-Fuentes, M, Toapanta, N, Franco, A, Burballa, C, Munoz, M, Crespo, M and Pascual, J
Publicada:
22 sep 2022
Ahead of Print:
1 jul 2022
Resumen:
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 m(2). 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.
Filiaciones:
Villanego, F:
Hosp Univ Puerta Del Mar, Dept Nephrol, Cadiz, Spain
Mazuecos, A:
Hosp Univ Puerta Del Mar, Dept Nephrol, Cadiz, Spain
Cubillo, B:
Hosp Clin San Carlos, Dept Nephrol, Madrid, Spain
Merino, M:
Hosp Univ Juan Ramon Jimenez, Dept Nephrol, Huelva, Spain
Poveda, I:
Hosp Univ Torrecardenas, Dept Nephrol, Almeria, Spain
Saura, I:
Hosp Clin Univ Virgen de la Arrixaca, Dept Nephrol, Murcia, Spain
Segurado, O:
Hosp Univ Puerta Del Mar, Dept Nephrol, Cadiz, Spain
:
Hosp Gen Univ Elche, Dept Nephrol, Elche, Spain
Eady, M:
Hosp Univ Jerez de la Frontera, Dept Nephrol, Jerez de la Frontera, Spain
Zarraga, S:
Hosp Univ Cruces, Dept Nephrol, Bilbao, Spain
Aladren, M:
Hosp Univ Miguel Servet, Dept Nephrol, Zaragoza, Spain
Cabello, S:
Hosp Univ Son Espases, Dept Nephrol, Palma De Mallorca, Spain
Lopez, V:
Univ Malaga, Hosp Reg Univ Malaga, Inst Invest Biomed Malaga, Dept Nephrol,REDinREN RD16 0009 0006, Malaga, Spain
Gonzalez, E:
Hosp Univ Doce Octubre, Inst Med Res I 12, Dept Nephrol, Madrid, Spain
Lorenzo, I:
Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain
Espi-Reig, J:
Hosp Univ & Politecn La Fe, Dept Nephrol, Valencia, Spain
Fernandez, C:
Complexo Hosp Univ A Coruna, Dept Nephrol, La Coruna, Spain
:
Hosp Univ Doctor Peset, Dept Nephrol, Valencia, Spain
Ruiz-Fuentes, M:
Hosp Univ Virgen de las Nieves, Dept Nephrol, Granada, Spain
Toapanta, N:
Hosp Valle De Hebron, Dept Nephrol, Barcelona, Spain
Franco, A:
Hosp Gen Univ Alicante, Dept Nephrol, Alicante, Spain
Burballa, C:
Hosp del Mar, Hosp del Mar Med Res Inst, Dept Nephrol, REDinREN RD16 0009 0013, Barcelona, Spain
Munoz, M:
Hosp Univ Toledo, Dept Nephrol, Toledo, Spain
Crespo, M:
Hosp del Mar, Hosp del Mar Med Res Inst, Dept Nephrol, REDinREN RD16 0009 0013, Barcelona, Spain
Pascual, J:
Hosp Univ Puerta Del Mar, Dept Nephrol, Cadiz, Spain
Hosp Clin San Carlos, Dept Nephrol, Madrid, Spain
Green Published, gold
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