AUTHOR=Papadimitriou-Olivgeris Matthaios , Cipriano Ana , Guggisberg Nicolas , Kroemer Marie , Tschopp Jonathan , Manuel Oriol , Golshayan Dela 

TITLE=Outcome of COVID-19 in Kidney Transplant Recipients Through the SARS-CoV-2 Variants Eras: Role of Anti-SARS-CoV-2 Monoclonal Antibodies

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10721

DOI=10.3389/ti.2022.10721

ISSN=1432-2277

ABSTRACT=Kidney transplant recipients (KTR) are at increased risk for COVID-19-associated complications. We aimed to describe the evolving epidemiology and outcome of PCR-documented SARS-CoV-2 infection in KTR followed at our institution from March 2020 to June 2022. The primary endpoint was hospitalization for COVID-19-related symptoms or death within 28 days from diagnosis. Overall, 68/243 (28%) patients developed the primary outcome. A significant decrease in the primary outcome was observed in later periods of our study (45% in early vs. 19% in late periods; P<0.001, r -0.342). Anti-Spike monoclonal antibodies (mAbs) were administered as preemptive treatment in 101 patients (14 with casirivimab/imdevimab and 87 with sotrovimab). Among 145 patients that had received at least one vaccination dose before infection, 109 (45%) of patients were considered as adequately vaccinated. Multivariate analysis revealed that the Charlson Comorbidity Index (P 0.001; OR 1.28, CI 1.11-1.48) was associated with the primary outcome, while preemptive administration of mAbs (P 0.032; OR 0.39, CI 0.16-0.92) was associated with a better outcome, but not infection during the period of omicron variant predominance or adequate vaccination. These results need to be confirmed in larger prospective studies.