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The Prevention of COVID-19 in High-Risk Patients Using Tixagevimab-Cilgavimab (Evusheld): Real-World Experience at a
Mohanad M Al-Obaidi1, Ahmet B Gungor2, Sandra E Kurtin3
1Division of Infectious Disease, College of Medicine, University of Arizona, Tucson.
Insights
Tixagevimab-cilgavimab (Tix-Cil) effectively prevented COVID-19 complications in immunocompromised patients. This high-risk group showed low rates of infection, hospitalization, and death after Tix-Cil administration during the Omicron variant period.
Area of Science:
- Immunology
- Infectious Diseases
- Pharmacology
Background:
- Immunocompromised patients face higher risks of severe COVID-19.
- Tixagevimab-cilgavimab (Tix-Cil) is a monoclonal antibody combination for COVID-19 prevention in high-risk individuals.
- Vaccine efficacy can be suboptimal in immunocompromised populations.
Purpose of the Study:
- To evaluate the effectiveness of Tixagevimab-cilgavimab (Tix-Cil) in preventing COVID-19 complications.
- To assess outcomes in immunocompromised patients receiving Tix-Cil during the Omicron variant surge.
- To analyze post-treatment infection, hospitalization, and mortality rates.
Main Methods:
- Retrospective chart review of 463 immunocompromised patients who received Tix-Cil.
- Data collection on comorbidities, COVID-19 infections, hospitalizations, and deaths.
- Follow-up analysis during the Omicron variant period (January-May 2022).
Main Results:
- Only 6.1% of patients tested positive for SARS-CoV-2 post-treatment.
- 9.1% of patients were hospitalized, and 0.9% died; no COVID-19 or Tix-Cil related deaths occurred.
- Hospitalizations and deaths were unrelated to COVID-19 or Tix-Cil treatment.
Conclusions:
- Tixagevimab-cilgavimab (Tix-Cil) demonstrates significant protection against COVID-19 complications in immunocompromised patients.
- The treatment is safe and effective for this vulnerable population, even with circulating variants.
- Tix-Cil serves as a crucial preventive measure for those with inadequate vaccine responses.
Background:
Coronavirus disease 2019 (COVID-19) is associated with increased morbidity and mortality among immunocompromised patients. Tixagevimab-cilgavimab (Tix-Cil) is a combination of 2 monoclonal antibodies approved for the prevention of COVID-19 complications in this high-risk group.
Methods:
We retrospectively reviewed the charts of patients who received Tix-Cil during the Omicron variant period (January 17 to April 23, 2022), with a follow-up period until May 24, 2022. We collected data about patient underlying comorbidities and post Tix-Cil COVID-19 infections, deaths, and hospitalizations.
Results:
There were 463 patients with a median age of 68 years, of which 51% were male, 79% White, 13.2% Hispanic, 1.7% Black/African American, and 5.8% identified as Other. A total of 18% had undergone a solid organ transplantation or hematopoietic stem cell transplantation. Only 6/98 (6.1%) had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detected by polymerase chain reaction (PCR) at a median 48 days (interquartile range [IQR] 27.5, 69) follow-up. Forty-two patients (9.1%) were hospitalized, and 4 (0.9%) died, but none were attributed to COVID-19 or Tix-Cil. One hospitalized patient had an incidental, asymptomatic, positive SARS-CoV 2 by PCR. The median days from Tix-Cil administration to non-COVID-19-related hospitalization and death were 30 (IQR 17, 55) and 53 (IQR 18, 91), respectively.
Conclusion:
Tix-Cil provides protection against COVID-19 complications in immunocompromised patients with suboptimal immune responses to vaccines.
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