Abstract
The SARS-CoV-2 pandemic continues to place a substantial burden on healthcare systems. Outpatient therapies for mild-to-moderate disease have reduced hospitalizations and deaths in clinical trials, but the real-world effectiveness of monoclonal antibodies and oral antiviral agents in solid organ transplant recipients (SOTR) with coronavirus disease-2019 (COVID-19) is largely uncharacterized. We conducted a single-center, retrospective review of 122 SOTR diagnosed with COVID-19 in the outpatient setting during the Omicron surge to address this knowledge gap. The mean age was 54 years, 57% were males, and 67% were kidney transplant recipients. The mean time from transplant to COVID-19 diagnosis was 75 months. Forty-nine (40%) received molnupiravir, 24 (20%) received sotrovimab, and 1 (0.8%) received nirmatrelvir/ritonavir. No outpatient therapy was administered in 48 (39%). All 122 SOTR had >30 days follow-up. Rates of hospitalization within 30 days of initiating therapy for molnupiravir, nirmatrelvir/ritonavir, and sotrovimab were 16% (8/49), 0% (0/1), and 8% (2/24), respectively, compared to 27% (13/48) in patients without outpatient therapy. There were no deaths in those who received any therapy versus 3 (6%) deaths in patients without outpatient therapy (p = .002). Overall, our experience suggests a role for monoclonal antibodies and oral antiviral agents in reducing COVID-19-related morbidity and mortality in SOTR.
Keywords: COVID-19; SARS-CoV-2; molnupiravir; nirmatrelvir; solid organ transplant; sotrovimab.
【저자키워드】 COVID-19, SARS-CoV-2, molnupiravir, Nirmatrelvir, Sotrovimab., solid organ transplant, 【초록키워드】 coronavirus, therapy, Hospitalization, knowledge, SARS-CoV-2 pandemic, monoclonal antibody, clinical trials, omicron, Patient, COVID-19 diagnosis, Effectiveness, death, age, morbidity and mortality, Follow-up, antiviral agent, Outpatient, retrospective, kidney transplant recipients, Healthcare systems, single-center, mild-to-moderate disease, recipient, organ, Administered, males, Rate, conducted, reduced, reducing, diagnosed with COVID-19, 【제목키워드】 therapy, recipient,