Passive pre-exposure immunization by tixagevimab/cilgavimab in patients with hematological malignancy and COVID-19: matched-paired analysis in the EPICOVIDEHA registry
Francesco Marchesi, Jon Salmanton‐García, Caterina Buquicchio, Federico Itri, Caroline Besson, Julio Dávila, Sonia Martín‐Pérez, Luana Fianchi, Laman Rahimli, Giuseppe Tarantini, Federica Irene Grifoni, Mariarita Sciumé, Jorge Labrador, Raúl Córdoba, Alberto López‐García, Nicola Fracchiolla, Francesca Farina, Emanuele Ammatuna, Antonella Cingolani, Daniel García-Bordallo, Stefanie K. Gräfe, Yavuz M. Bilgin, Michelina Dargenio, Tomás José González‐López, Anna Guidetti, Tobias Lahmer, Esperanza Lavilla, Gustavo‐Adolfo Méndez, Lucia Prezioso, Martin Schönlein, Jaap A. van Doesum, Dominik Wolf, Ditte Stampe Hersby, Ferenc Magyari, Jens Van Praet, Verena Petzer, Carlo Tascini, Iker Falces‐Romero, Andreas Glenthøj, Oliver A. Cornely, Livio Pagano
Abstract
Only few studies have analyzed the efficacy of tixagevimab/cilgavimab to prevent severe Coronavirus disease 2019 (COVID-19) and related complications in hematologic malignancies (HM) patients. Here, we report cases of breakthrough COVID-19 after prophylactic tixagevimab/cilgavimab from the EPICOVIDEHA registry). We identified 47 patients that had received prophylaxis with tixagevimab/cilgavimab in the EPICOVIDEHA registry. Lymphoproliferative disorders (44/47, 93.6%) were the main underlying HM. SARS-CoV-2 strains were genotyped in 7 (14.9%) cases only, and all belonged to the omicron variant. Forty (85.1%) patients had received vaccinations prior to tixagevimab/cilgavimab, the majority of them with at least two doses. Eleven (23.4%) patients had a mild SARS-CoV-2 infection, 21 (44.7%) a moderate infection, while 8 (17.0%) had severe infection and 2 (4.3%) critical. Thirty-six (76.6%) patients were treated, either with monoclonal antibodies, antivirals, corticosteroids, or with combination schemes. Overall, 10 (21.3%) were admitted to a hospital. Among these, two (4.3%) were transferred to intensive care unit and one (2.1%) of them died. Our data seem to show that the use of tixagevimab/cilgavimab may lead to a COVID-19 severity reduction in HM patients; however, further studies should incorporate further HM patients to confirm the best drug administration strategies in immunocompromised patients.