Efficacy of pre-exposure prophylaxis to prevent SARS-CoV-2 infection after lung transplantation : a two center cohort study during the omicron era

© 2023. The Author(s)..

PURPOSE: Lung transplant (LTx) recipients are at risk for poor outcomes from coronavirus disease 2019 (COVID-19). The aim of the study was to assess the outcome of patients receiving pre-exposure prophylaxis (PrEP) with tixagevimab and cilgavimab after LTx.

METHODS: All LTx recipients with outpatient visits from February 28th to October 31st, 2022 at two German centers were included. Baseline characteristics were recorded and patients followed until November 30rd, 2022. Infections with SARS-CoV-2, disease severity, and COVID-19-associated death were compared between patients with and without PrEP.

RESULTS: In total, 1438 patients were included in the analysis, and 419 (29%) received PrEP. Patients receiving PrEP were older and earlier after transplantation, had lower glomerular filtration rates, and lower levels of SARS-CoV-2-S antibodies. In total, 535 patients (37%) developed SARS-CoV-2 infection during a follow-up of median of 209 days. Fewer infections occurred in patients with PrEP during the study period (31% vs. 40%, p = 0.004). Breakthrough SARS-CoV-2 infections after PrEP occurred in 77 patients (19%). In total, 37 infections (8%) were severe or critical. No difference in severity of COVID-19 was observed between patients with and without PrEP. There were 15 COVID-19-associated deaths (n = 1 after PrEP). Compared to matched controls, there was a non-significant difference towards a lower risk for moderate to critical COVID-19 (p 0.184).

CONCLUSION: The number of SARS-CoV-2 infections was lower in LTx recipients with PrEP. Despite being at higher risk for worse outcome severity of COVID-19 and associated mortality were similar in patients with and without PrEP.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Infection - 51(2023), 5 vom: 08. Okt., Seite 1481-1489

Sprache:

Englisch

Beteiligte Personen:

Gottlieb, Jens [VerfasserIn]
Simon, Susanne [VerfasserIn]
Barton, Jürgen [VerfasserIn]
Barnikel, Michaela [VerfasserIn]
Bachmann, Marcus [VerfasserIn]
Klingenberg, Merle-Sophie [VerfasserIn]
Veit, Tobias [VerfasserIn]
Kneidinger, Nikolaus [VerfasserIn]

Links:

Volltext

Themen:

Antibodies
Antibodies, Viral
COVID-19
Cilgavimab
Journal Article
Lung transplantation
Monoclonal
Pre-exposure prophylaxis
Prophylaxis
SARS-CoV-2
Tixagevimab

Anmerkungen:

Date Completed 23.10.2023

Date Revised 23.10.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s15010-023-02018-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM354351265