Sotrovimab effective treatment option for COVID-19 infection in Kidney Transplant Recipients

SPAIN: According to research published in Clinical Kidney Journal, the monoclonal antibody sotrovimab can be safely utilized in kidney transplant patients with COVID-19, including older people and those with comorbidities.

A neutralizing monoclonal antibody (mAb) called sotrovimab appears to continue to be effective against more current SARS-CoV-2 mutations. But there is little research on its application to kidney transplant (KT) recipients.

"Our findings demonstrate the good safety profile of sotrovimab. Additionally, the treatment seems to work well and may stop the progression of a serious condition in these high-risk patients when it is given in the first few days following the onset of symptoms, "the investigators claimed.

KT from around the country who tested positive for COVID-19 were the subject of an analysis by the authors.

82 kidney transplant recipients with COVID-19 were the subject of a retrospective research, of which 46 (56%) received sotrovimab within 5 days of symptom initiation (early group), and 36 (44%) received it after 5 days (late group). 40 (97.5%) of the 41 individuals whose SARS-CoV-2 genotype was identified had the Omicron variant.

Key points of the study:

• Those who received treatment earlier had a lower risk of developing severe COVID-19, as evidenced by a lower need for ventilator support (2.2% vs. 36.1%; P< .001), a lower rate of intensive care admission (2.2% vs. 25%; P =.002), and a lower rate of COVID-19-related mortality (2.2% vs. 16.7%; P =.020).
• Early use of sotrovimab was found to be a protective factor against a composite outcome that included the need for intensive care, the necessity for ventilator support, and COVID-19-related mortality in the multivariable analysis, which controlled for baseline risk factors to severe COVID-19 in KT recipients.
• There were no sotrovimab-related anaphylactic responses, acute rejection episodes, events involving reduced kidney function, or non-kidney side effects.
• 6 of the 7 fatal patients received sotrovimab more than five days after the other patients.
• In comparison to the recovered group, the deceased group displayed a more severe COVID-19 disease and had more pneumonia.
• They had higher comorbidities overall, particularly cardiovascular disease, and were also much older (72 versus 63 years).

The investigators claim that these potential variables make it difficult to draw definitive findings about sotrovimab's effectiveness in kidney transplant recipients.

In these individuals who have a high rate of vaccination nonresponse, "our research emphasizes the necessity of an early diagnosis," the authors wrote in their conclusion.

To clarify the true efficacy of mAb treatments in this extremely vulnerable population, they continued, bigger randomized clinical trials involving SOT recipients are required.

REFERENCE

Florentino Villanego, Auxiliadora Mazuecos, Beatriz Cubillo, M José Merino, Inmaculada Poveda, Isabel M Saura, Óscar Segurado, Leónidas Cruzado, Myriam Eady, Sofía Zárraga, M José Aladrén, Sheila Cabello, Verónica López, Esther González, Inmaculada Lorenzo, Jordi Espí-Reig, Constantino Fernández, July Osma, M Carmen Ruiz-Fuentes, Néstor Toapanta, Antonio Franco, Carla C Burballa, Miguel A Muñoz, Marta Crespo, Julio Pascual, Treatment with sotrovimab for SARS-CoV-2 infection in a cohort of high-risk kidney transplant recipients, Clinical Kidney Journal, Volume 15, Issue 10, October 2022, Pages 1847–1855,

https://doi.org/10.1093/ckj/sfac177