Monoclonal Antibody Therapy for COVID-19 in Solid Organ Transplant Recipients

• Published in: Open forum infectious diseases 2021-06, Vol.8 (6), p.ofab255-ofab255
• Main Authors: Yetmar, Zachary A, Beam, Elena, O’Horo, John C, Ganesh, Ravindra, Bierle, Dennis M, Brumble, Lisa, Seville, Maria Teresa, Razonable, Raymund R
• Format: Article
• Language: English
• Subjects: Editor's Choice; Major
• ISSN: 2328-8957; 2328-8957
• DOI: 10.1093/ofid/ofab255

Abstract BackgroundBamlanivimab and casirivimab-imdevimab are authorized for emergency use treatment of mild to moderate coronavirus disease 2019 (COVID-19) in patients at high risk for developing severe disease or hospitalization. Their safety and efficacy have not been specifically evaluated in solid organ transplant recipients. MethodsWe retrospectively reviewed solid organ transplant recipients who received monoclonal antibody infusion for COVID-19 at Mayo Clinic sites through January 23, 2021. Outcomes included emergency department visit, hospitalization, mortality, and allograft rejection. ResultsSeventy-three patients were treated, most commonly with bamlanivimab (75.3%). The median age was 59 years, 63% were male, and the median Charlson comorbidity index was 5. Transplant type included 41 kidney (56.2%), 13 liver (17.8%), 11 heart (15.1%), 4 kidney-pancreas (5.5%), 2 lung (2.7%), 1 heart-liver, and 1 pancreas. Eleven (15.1%) patients had an emergency department visit within 28 days of infusion, including 9 (12.3%) who were hospitalized for a median of 4 days. One patient required intensive care unit admission for a nonrespiratory complication. No patients required mechanical ventilation, died, or experienced rejection. Ten adverse events occurred, with 1 seeking medical evaluation. Hypertension was associated with hospital admission (P