Tixagevimab/Cilgavimab As SARS-CoV-2 Pre-Exposure Prophylaxis in Lung Transplant Recipients During the Omicron Wave: A Real-World Monocentric Experience

Overview

Journal Microorganisms

Specialty Microbiology

Date 2024 Jul 27

PMID 39065204

Authors

Andrea Cona

Alessandro Tavelli

Stefano Agrenzano

Neha Hafeez

Giovanni Scianna

Angelo Maria

Francesco Marino

Elizabeth De La Cruz

Maria Di Giorgio

Eglys Osorio

Giuseppe Cucinella

Angelo Luca

Alessio Provenzani

Patrizio Vitulo

Alessandro Bertani

Paolo Antonio Grossi

Alessandra Mularoni

Affiliations

Soon will be listed here.

Abstract

Lung transplant recipients (LTRs) respond poorly to vaccination. SARS-CoV-2 pre-exposure prophylaxis (PrEP) with tixagevimab/cilgavimab (TIX/CIL) reduces the incidence of infection and the evolution to severe COVID-19. In vitro data show decreased activity against Omicron variants. We evaluated the clinical efficacy and safety of TIX/CIL in LTRs during the Omicron wave. A prospective observational cohort study was conducted at ISMETT in Palermo (Italy). In June 2022, SARS-CoV-2 PrEP with TIX/CIL 150/150 mg was offered to LTRs. LTRs who received TIX/CIL were compared to LTRs who did not. Logistic regression analysis (adjusted for prior COVID-19, SARS-CoV-2 vaccination, age, years from transplant, and rejection) was performed. The objective of this study was to compare the following among the two populations: prevalence of SARS-CoV-2, length of SARS-CoV-2 positivity, and COVID-19 disease severity. Among 110 eligible LTRs, 79 (72%) received TIX/CIL and 31 (28%) did not. SARS-CoV-2 infections occurred in 6% (n = 5) of patients who received TIX/CIL and 29% (n = 9) of patients who did not ( < 0.001). In both groups, infections were mild/asymptomatic, and no one was hospitalized or died. At multivariate analysis, TIX/CIL was associated with a lower risk of infection (aOR 0.22; 95%CI 0.06-0.78; = 0.02). TIX/CIL was safe and effective in reducing the risk of SARS-CoV-2 in LTRs during the Omicron wave.

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