Abstract
BACKGROUND AND AIMSCasirivimab/imdevimab (C/I) is a combination of two neutralizing human monoclonal antibodies against the SARS-CoV-2. It has been approved for primary prophylaxis or acute SARS-CoV-2 infection in patients with a poor vaccine response. Chronic haemodialyzed (CHD) patients are a high-risk population for both severe COVID-19 and impaired vaccine response. We herein report the safety and efficiency of C/I in CHD patients with acute mild COVID-19.METHODIn a single-centre haemodialysis facility, all 56 CHD patients received 3 injections of anti-COVID-19 mRNA BNT162b2 vaccine, with anti-S protein antibodies response assessed 7 months after the last injection. During follow-up, patients who presented an acute mild SARS-CoV-2 infection without the need for oxygen therapy and a poor vaccine response received within 5 days after diagnosis 600mg/600mg of C/I. The combination of monoclonal antibodies was infused only once after the end of the dialysis session during 20 min. Patients were kept under surveillance during 1 h before discharge. Efficiency was assessed by RT-PCR 7 days after C/I infusion and clinical evaluation.RESULTSSix CHD patients had an acute COVID-19 without oxygen therapy requirement and four had a vaccine response < 264 BAU/mL. Among them three had the Delta variant (L452R mutation), and received C/I. Two of them had the opportunity to have a fourth vaccine injection, but got infected within 2 weeks after the boost. Clinical data are summarized in Table 1. No patient presented any adverse effect within the time in the dialysis facility. During follow-up, all patients remained asymptomatic and all control RT-PCR performed 7 days after infusion were negative.CONCLUSION600 mg/600 mg of C/I is a safe and efficient treatment for CHD patients with a poor vaccine humoral response presenting mild acute Delta variant COVID-19 without oxygen requirement.Table 1.Clinical and biological data of CHD patients receiving C/I. Asymptomatic patients were warned of by their close circle to be case contactPatientGenderAgeVintage on dialysis (years)Number of vaccine dosesAnti-S antibodies titer (BAU/mL)Clinical presentationTime between last vaccine and COVID-19 diagnosis (days)1F9112397.8Asymptomatic2202M760.54237.2Asymptomatic113M83444.2Fever, chills12
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
