COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis
Lung transplant (LTx) recipients are at high risk for COVID-19 related morbidity and mortality. Data regarding pre-exposure prophylaxis (PrEP) with tixagevimab-cilgavimab in this population are scarce. We therefore evaluated COVID-19 breakthrough infections and COVID-19 related complications after P...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12061/full |
| _version_ | 1797221046331375616 |
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| author | Saartje Demolder Veronique Schaevers Katrien Lagrou Katrien Lagrou Paul De Munter Paul De Munter Hanne Beeckmans Geert M. Verleden Geert M. Verleden Laurent Godinas Laurent Godinas Lieven J. Dupont Lieven J. Dupont Pascal Van Bleyenbergh Natalie Lorent Natalie Lorent Robin Vos Robin Vos |
| author_facet | Saartje Demolder Veronique Schaevers Katrien Lagrou Katrien Lagrou Paul De Munter Paul De Munter Hanne Beeckmans Geert M. Verleden Geert M. Verleden Laurent Godinas Laurent Godinas Lieven J. Dupont Lieven J. Dupont Pascal Van Bleyenbergh Natalie Lorent Natalie Lorent Robin Vos Robin Vos |
| author_sort | Saartje Demolder |
| collection | DOAJ |
| description | Lung transplant (LTx) recipients are at high risk for COVID-19 related morbidity and mortality. Data regarding pre-exposure prophylaxis (PrEP) with tixagevimab-cilgavimab in this population are scarce. We therefore evaluated COVID-19 breakthrough infections and COVID-19 related complications after PrEP in a retrospective single-center study, including 264 LTx recipients who received PrEP between June 2022 and December 2022, when Omicron BA.5 was the dominant circulating SARS-CoV-2 variant. PrEP was indicated for fully vaccinated patients with poor seroconversion (anti-S <260 BAU/mL). COVID-19 breakthrough infection after PrEP occurred in 11.0% within the first 3 months, increasing to 17.4% within 6 months. Hospitalization rate rose from 27.6% to 52.9% (p = 0.046), while ICU admissions and COVID-19 mortality remained low, respectively occurring in 6.5% and 4.3% of patients with breakthrough infection within 6 months. COVID-19 breakthrough infection and associated hospitalization remained an important problem during the Omicron BA.5 surge in fully vaccinated LTx recipients with deficient seroconversion, despite PrEP with tixagevimab-cilgavimab. However, ICU admissions and COVID-19 mortality were low. Waning of neutralizing effects of PrEP and changing circulating SARS-CoV-2 variants may explain increases in COVID-19 infections and hospitalizations over time after PrEP, highlighting the need for novel, long-term effective PrEP strategies in these high-risk patients. |
| first_indexed | 2024-04-24T12:59:12Z |
| format | Article |
| id | doaj.art-f71bae62342141ceb7df5b8eb5eab929 |
| institution | Directory Open Access Journal |
| issn | 1432-2277 |
| language | English |
| last_indexed | 2024-04-24T12:59:12Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj.art-f71bae62342141ceb7df5b8eb5eab9292024-04-05T16:29:08ZengFrontiers Media S.A.Transplant International1432-22772024-01-013710.3389/ti.2024.1206112061COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center AnalysisSaartje Demolder0Veronique Schaevers1Katrien Lagrou2Katrien Lagrou3Paul De Munter4Paul De Munter5Hanne Beeckmans6Geert M. Verleden7Geert M. Verleden8Laurent Godinas9Laurent Godinas10Lieven J. Dupont11Lieven J. Dupont12Pascal Van Bleyenbergh13Natalie Lorent14Natalie Lorent15Robin Vos16Robin Vos17Department of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumLung Transplant Team, University Hospitals Leuven, Leuven, BelgiumDepartment of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumDepartment of General Internal Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumDepartment of Respiratory Diseases, University Hospitals Leuven, Leuven, BelgiumDepartment of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, BelgiumLung transplant (LTx) recipients are at high risk for COVID-19 related morbidity and mortality. Data regarding pre-exposure prophylaxis (PrEP) with tixagevimab-cilgavimab in this population are scarce. We therefore evaluated COVID-19 breakthrough infections and COVID-19 related complications after PrEP in a retrospective single-center study, including 264 LTx recipients who received PrEP between June 2022 and December 2022, when Omicron BA.5 was the dominant circulating SARS-CoV-2 variant. PrEP was indicated for fully vaccinated patients with poor seroconversion (anti-S <260 BAU/mL). COVID-19 breakthrough infection after PrEP occurred in 11.0% within the first 3 months, increasing to 17.4% within 6 months. Hospitalization rate rose from 27.6% to 52.9% (p = 0.046), while ICU admissions and COVID-19 mortality remained low, respectively occurring in 6.5% and 4.3% of patients with breakthrough infection within 6 months. COVID-19 breakthrough infection and associated hospitalization remained an important problem during the Omicron BA.5 surge in fully vaccinated LTx recipients with deficient seroconversion, despite PrEP with tixagevimab-cilgavimab. However, ICU admissions and COVID-19 mortality were low. Waning of neutralizing effects of PrEP and changing circulating SARS-CoV-2 variants may explain increases in COVID-19 infections and hospitalizations over time after PrEP, highlighting the need for novel, long-term effective PrEP strategies in these high-risk patients.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12061/fullCOVID-19lung transplantationpre-exposure prophylaxistixagevimab-cilgavimaboutcome predictors |
| spellingShingle | Saartje Demolder Veronique Schaevers Katrien Lagrou Katrien Lagrou Paul De Munter Paul De Munter Hanne Beeckmans Geert M. Verleden Geert M. Verleden Laurent Godinas Laurent Godinas Lieven J. Dupont Lieven J. Dupont Pascal Van Bleyenbergh Natalie Lorent Natalie Lorent Robin Vos Robin Vos COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis Transplant International COVID-19 lung transplantation pre-exposure prophylaxis tixagevimab-cilgavimab outcome predictors |
| title | COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis |
| title_full | COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis |
| title_fullStr | COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis |
| title_full_unstemmed | COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis |
| title_short | COVID-19 Outcomes in Lung Transplant Recipients Following Pre-Exposure Prophylaxis With Tixagevimab-Cilgavimab During the Omicron BA.5 Surge: A Single Center Analysis |
| title_sort | covid 19 outcomes in lung transplant recipients following pre exposure prophylaxis with tixagevimab cilgavimab during the omicron ba 5 surge a single center analysis |
| topic | COVID-19 lung transplantation pre-exposure prophylaxis tixagevimab-cilgavimab outcome predictors |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12061/full |
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