Early Administration of Anti–SARS-CoV-2 Monoclonal Antibodies Prevents Severe COVID-19 in Kidney Transplant Patients
Juliette Gueguen, Charlotte Colosio, Arnaud Del Bello, Anne Scemla, Yohan N’Guyen, Claire Rouzaud, Claudia Carvalho-Schneider, Gabriela Gautier-Vargas, Pierre Tremolières, A. Jalal Eddine, Christophe Masset, Olivier Thaunat, Melchior Chabannes, Paulo Malvezzi, Pierre Pommerolle, Lionel Couzi, Nassim Kamar, Sophie Caillard, Philippe Gatault
Abstract
IntroductionKidney transplant recipients (KTRs) are prone to develop severe COVID-19 and are less well protected by vaccine than immunocompetent subjects. Thus, the use of neutralizing anti–SARS-CoV-2 monoclonal antibody (MoAb) to confer a passive immunity appears attractive in KTRs.MethodsWe performed a French nationwide study to compare COVID-19–related hospitalization, 30-day admission to intensive care unit (ICU), and 30-day death between KTRs who received an early infusion of MoAb (MoAb group) and KTRs who did not (control group). Controls were identified from the COVID-SFT registry (NCT04360707) using a propensity score matching with the following covariates: age, sex, delay between transplantation and infection, induction and maintenance immunosuppressive therapy, initial symptoms, and comorbidities.ResultsA total of 80 KTRs received MoAb between February 2021 and June 2021. They were matched to 155 controls. COVID-19–related hospitalization, 30-day admission to ICU, and 30-day death were less frequently observed in the MoAb group (35.0% vs. 49.7%, P = 0.032; 2.5% vs. 15.5%, P = 0.002; 1.25% vs. 11.6%, P = 0.005, respectively). No patient required mechanical ventilation in the MoAb group. The number of patients to treat to prevent 1 death was 9.7.ConclusionThe early use of MoAb in KTRs with a mild form of COVID-19 largely improved outcomes in KTRs.