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Kidney Week

Abstract: PO2093

Treatment with Monoclonal Antibodies Minimize Severity of COVID-19 Illness Among Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Pynadath, Cindy T., Montefiore Health System, Bronx, New York, United States
  • Bartash, Rachel, Montefiore Health System, Bronx, New York, United States
  • Al Azzi, Yorg, Montefiore Health System, Bronx, New York, United States
  • Loarte Campos, Pablo, Montefiore Health System, Bronx, New York, United States
  • Ajaimy, Maria, Montefiore Health System, Bronx, New York, United States
  • Liriano-Ward, Luz E., Montefiore Health System, Bronx, New York, United States
  • Campbell, Alesa, Montefiore Health System, Bronx, New York, United States
  • Akalin, Enver, Montefiore Health System, Bronx, New York, United States
Background

The mortality rate of kidney transplant recipients with COVID-19 is significantly higher than the general population, indicating a need for effective treatment to minimize potential severe symptoms in this population. We sought to evaluate the efficacy of monoclonal antibody therapy in decreasing the severity of COVID-19 symptoms among our kidney transplant recipients.

Methods

We reviewed 17 kidney transplant recipients who were infected with SARS-CoV2 and received treatment with monoclonal antibody therapy. All patients were on standard immunosuppression with Tacrolimus and Prednisone, and 88% were on Mycophenolate prior to COVID diagnosis, which was subsequently reduced or held for at least 2 weeks.

Results

Of the 17 patients reviewed, median age was 61 years (range 42 to 77 years), 47% were male, 59% were Hispanic, and 29% were African American. Additionally 94% had history of hypertension, 47% diabetes mellitus, 18% coronary artery disease, and median BMI was 28.8 (range 23.4 to 41.9). Eighteen percent were transplanted <1 year, 29% between 1-5 years, 24% 6-10 years, and the remaining >10 years. All patients had mild symptoms without evidence of hypoxia, and 94% received monoclonal antibody therapy within 7 days of diagnosis. Bamlanivimab 700mg was the most commonly administered agent at 59%, while 18% received Bamlanivimab 700mg and Etesevimab 1400mg. Casirivimab 1200 mg and imdevimab 1200 mg was used in 24%. Only 2 out of the 17 patients (11.8%) required hospitalization, and both were non-COVID-19 related reasons. Five out of 17 patients (29.4%) were evaluated in the Emergency Department but not admitted. All 17 patients (100%) recovered from their COVID-19 illness. There were no episodes of graft failure.

Conclusion

Our experience suggests that monoclonal antibody therapies may be beneficial in preventing severe COVID-19 in renal transplant recipients and possibly reduce the need for COVID-19 related hospitalization in this high risk population. However, larger studies are needed to confirm these findings.