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SARS-CoV-2 infection in high-risk children following tixagevimab-cilgavimab (Evusheld) pre-exposure prophylaxis: a

Diego R Hijano1, Jose A Ferrolino1, Elizabeth G Swift2

  • 1Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States.

Frontiers in Oncology
|August 21, 2023
PubMed

Insights

Tixagevimab-cilgavimab (T-C) provided pre-exposure COVID-19 prophylaxis for 24 patients. While most tolerated T-C well, seven individuals contracted SARS-CoV-2, with one experiencing severe illness.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Tixagevimab-cilgavimab (T-C) was authorized for COVID-19 pre-exposure prophylaxis from December 2021 to January 2023.
  • This monoclonal antibody combination aimed to prevent SARS-CoV-2 infection in vulnerable populations.

Purpose of the Study:

  • To evaluate the real-world administration and outcomes of tixagevimab-cilgavimab (T-C) for COVID-19 pre-exposure prophylaxis.
  • To assess the safety and efficacy of T-C in a clinical setting.

Main Methods:

  • A multidisciplinary team managed the screening, administration, and follow-up of eligible patients.
  • Data collection focused on patient demographics, vaccination status, T-C dosage, and SARS-CoV-2 infection events.

Main Results:

  • Twenty-four out of twenty-seven eligible patients received at least one dose of T-C.
  • The majority of recipients were White, non-Hispanic women; most were vaccinated against SARS-CoV-2.
  • Seven patients (29.2%) developed SARS-CoV-2 infection within 180 days, with one case of severe COVID-19 requiring ICU care. No serious adverse events were reported.

Conclusions:

  • Tixagevimab-cilgavimab (T-C) was administered to a cohort of patients for COVID-19 pre-exposure prophylaxis with a favorable safety profile.
  • Despite prophylaxis, breakthrough SARS-CoV-2 infections occurred, highlighting the need for ongoing surveillance and potential for severe disease in some individuals.

Keywords:
cancercoronavirushematopoietic cell transplantimmunocompromisedmonoclonal antibodies

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