Decoding REGEN-COV2 for Mild to Moderate SARS-CoV-2 Infection in Kidney Transplant Recipients
Kidney transplant recipients are an immunocompromised population, with comorbid conditions such as obesity, diabetes, and coronary artery disease, which increases their risk for progressing to severe COVID-19. Although COVID-19 vaccination is currently widespread and recommended for the prevention of severe COVID-19 infection, some transplant programs delay administering vaccinations immediately post-transplant to avoid all immune stimulation. Also, immunosuppressed kidney transplant recipients may have impaired antibody responses.
In the current study, REGN-COV2 was administered to 14 kidney transplant recipients with mild to moderate COVID-19 infection. To be eligible for REGN-COV2, all recipients must test positive by nasopharyngeal swab for SARS-CoV-2 via RT-PCR.
- The median age of treated recipients was 62 years (IQ range 52-69), and the median time from transplant was 5 years (IQ range 1-9)
- Preexisting risk factors for the severe disease were identified in our recipients and included age > 65 years, hypertension, coronary disease, and diabetes mellitus.
- The median time to REGN-COV2 infusion was 5 days (interquartile range 4-7).
- 3/14 recipients received corticosteroid maintenance therapy. Overall, immunosuppression was reduced in 6 patients after COVID-19 diagnosis.
- A single REGN-COV2 infusion of casirivimab 1200 mg and imdevimab 1200 mg was tolerated by our kidney transplant recipients.
- No cases of hypersensitivity reactions were observed.
- During infusion, 1 adverse event occurred where a recipient complained of burning sensation in the hands, which resolved following a dose of acetaminophen.
- 1 individual, aged 61 years, was hospitalized 6 days after infusion for worsening symptoms and required supplemental oxygen. This patient received dexamethasone, remdesivir, and tocilizumab, and up to 15 L oxygen. Further, the patient continued to improve and no longerneed oxygen supplement 2 weeks after discharge.
In kidney transplant recipients who are unable to obtain or have impaired antibody response to vaccinations, timely administration of REGN-COV2 in COVID-19–positive kidney transplant recipients may prevent progression to severe illness.
Conclusion:Neutralizing antibody therapy with REGN-COV2 was well tolerated and will continue to be useful in kidney transplant recipients with mild to moderate COVID-19 regardless of vaccination status.
Liu EC, Lee JH, Loo A, MazurS, Sultan S, Aull M, Lee JB, MuthukumarT, Hartono C. Casirivimab-Imdevimab (REGN-COV2) for Mild to Moderate SARS-CoV-2 Infection in Kidney Transplant Recipients. Kidney Int Rep. 2021 Nov;6(11):2900-2902.
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Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as an Editor-in-Chief for the Speciality Medical Dialogues section. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Before Joining Medical Dialogues, he has served at important positions in the medical industry in India including as the Hony. Secretary of the Delhi Medical Association as well as the chairman of Anti-Quackery Committee in Delhi and worked with other Medical Councils in India. Email: firstname.lastname@example.org. Contact no. 011-43720751