COVID-19 therapeutics and outcomes among solid organ transplant recipients during the Omicron BA.1 era

Hedvat, Jessica; Lange, Nicholas W; Salerno, David M.; DeFilippis, Ersilia M.; Kovac, Danielle; Corbo, Heather; Chen, Justin K.; Choe, Julie C; Lee, Jennifer H.; Anamisis, Anastasia; Jennings, Douglas L.; Codispodo, Giovanna; Shertel, Tara; Brown, Robert S.; Pereira, Marcus R.

doi:10.1111/ajt.17140

Cited by 43 publications

(68 citation statements)

References 21 publications

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“…Figure 1 shows the flow diagram of study selection according to its title, abstract, and full text. After removing duplicated records, seventeen studies, 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 (two RCTs and fifteen observational studies) with 27,429 patients were included in the meta‐analysis. The main characteristics of included studies are listed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Data are available online for the included studies. 19,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]…”

Section: Author Contributionsmentioning

confidence: 99%

“…Data are available online for the included studies. 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 …”

Section: Data Availability Statementmentioning

confidence: 99%

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Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

Amani

2022

Reviews in Medical Virology

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The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID‐19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID‐19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta‐analysis was performed using Comprehensive Meta‐Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25–0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43–0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25–0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33–0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17–0.67, p = 0.00) of the sotrovimab‐receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16–1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83–1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78–1.23, p = 0.88). The findings of the present meta‐analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID‐19.

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Section: Resultsmentioning

confidence: 99%

“…Data are available online for the included studies. 19,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]…”

Section: Author Contributionsmentioning

confidence: 99%

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Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

Amani

2022

Reviews in Medical Virology

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“…Furthermore, we assume that more stringent outpatient management of the LTR with breakthrough infections might have prevented the development of AKI and bacterial superinfections leading to hospitalizations in several cases, as would have the early initiation of antiviral treatment. In several published studies, the use of antiviral and early antibody treatment which showed excellent tolerability significantly reduced mortality, and the need for supplemental oxygen in SOT [ 39 , 40 , 41 , 42 , 43 , 44 ]. Therefore, early administration of antiviral treatment should be considered in LTR with comorbidities and a higher age who are thus at an increased risk for a severe disease course.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of SARS-CoV-2 Breakthrough Infections in Liver Transplant Recipients during the Omicron Wave

Herting

Jahnke-Triankowski

Harberts

et al. 2023

Viruses

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At the start of the pandemic, liver transplant recipients (LTR) were at high risk of developing severe COVID-19. Here, the outcomes of breakthrough infections in fully vaccinated LTR (n = 98) during the Omicron wave were assessed. In most patients, a mild disease course was observed, but 11 LTR (11.2%) required hospitalization for COVID-19-related complications. All patients survived. The LTR requiring hospitalization were older (67 years vs. 54 years; p < 0.001), had a higher Charlson comorbidity index (9 vs. 5; p < 0.001), and a lower anti-S RBD titer (Roche Elecsys) prior to infection (508.3 AU/mL vs. 2044 AU/mL; p = 0.03). Long-lasting symptoms for ≥4 weeks were reported by 37.5% of LTR (30/80). Risk factors in LTR included female sex (p = 0.01; Odds Ratio (OR) = 4.92 (95% confidence interval (CI) (1.5–16.5)) and dyspnea (p = 0.009; OR = 7.2 (95% CI (1.6–31.6)) during infection. Post-infection high anti-S RBD antibody levels were observed in LTR, and healthy controls (HC), while the cellular immune response, assessed by interferon-gamma release assay (EUROIMMUN), was significantly lower in LTR compared with HC (p < 0.001). In summary, in fully vaccinated LTR, SARS-CoV-2 breakthrough infections during the Omicron wave led to mild disease courses in the majority of patients and further boosted the humoral and cellular hybrid anti-SARS-CoV-2-directed immune response. While all patients survived, older and multimorbid LTR with low baseline antibody titers after vaccination still had a substantial risk for a disease course requiring hospitalization due to COVID-19-related complications.

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“…A similar study evaluated nirmatrelvir/ritonavir, sotrovimab and no SARS-CoV-2 specific treatment (92). The results are similar and claim for the use of SARS-CoV-2 specific agents in the treatment of SOT recipients with COVID-19 infection.…”

Section: Direct-acting Small Molecule Sars-cov-2 Antiviralsmentioning

confidence: 59%

What is New in Prophylaxis and Treatment of Covid- 19 in Renal Transplant Patients?

Salvadori¹

2022

Preprint

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Kidney transplant recipients, because of a weak immune response due to the assumption of immunosuppressant are exposed to the risk of COVID-19 infection. This fact realize the problem on how to treat the severe infection without carrying the risk of acute rejection due to the reduction of the immunosuppressive drugs. The best are the prophylactic measures to be taken before transplantation as vaccination. If the patient is already transplanted, three measures may be undertaken: Vaccination, use of monoclonal antibodies, use of therapeutic antiviral small molecules. Concerning vaccination is still debated which one is the best and how many doses should be given. The surge of new virus variant is the major problem and invites to find new active vaccines. In addition, not all the transplanted patients develop antibodies. The other measure is the use of monoclonal antibodies. They may be used as prophylaxis or in the early stage of the disease. Finally, the antiviral small molecules may be used again as prophylaxis or treatment. Their major drawback are the interference with the immunosuppressive drugs and the fact that some of them cannot be administered to patients with low eGFR.

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COVID-19 therapeutics and outcomes among solid organ transplant recipients during the Omicron BA.1 era

Cited by 43 publications

References 21 publications

Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

Clinical Outcomes of SARS-CoV-2 Breakthrough Infections in Liver Transplant Recipients during the Omicron Wave

What is New in Prophylaxis and Treatment of Covid- 19 in Renal Transplant Patients?

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