BRIEF RESEARCH REPORT article
Front. Transplant.
Sec. Transplantation Immunology
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1579226
Clinical outcomes in kidney transplant recipients receiving tixagevimab/cilgavimab for outpatient treatment of COVID-19: a single-center retrospective study
Provisionally accepted
Bilgin Osmanodja*
Friederike Bachmann
Mira Choi
Wiebke Duettmann
Georgios Eleftheriadis
Fabian Halleck
Marcel G. Naik
Eva SchrezenmeierBianca Zukunft
Klemens Budde- Department of Nephrology and Medical Intensive Care, Charité University Medicine Berlin, Berlin, Germany
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Kidney transplant recipients (KTR) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. Outpatient treatment with tixagevimab/cilgavimab prevented clinical deterioration in unvaccinated patients with COVID-19 during periods of Alpha and Delta dominance. Data on the clinical outcomes in KTR receiving tixagevimab/cilgavimab for outpatient treatment during Omicron dominance are scarce.We retrospectively analyzed the clinical outcomes in a single-center cohort of 102 KTR who received tixagevimab/cilgavimab for outpatient treatment of SARS-CoV-2 infection within 7 days after symptom onset between June 29, 2022, and April 4, 2023 and compared them to a historical cohort of 219 KTR, who were infected during the Omicron period, but before tixagevimab/cilgavimab treatment was employed at our institution (January 15 until June 28, 2022). The hospitalization rate and need for ICU treatment was lower in the tixagevimab/cilgavimab group compared to the control group (2.9% vs. 15.5%, p=0.001, and 0% vs. 5.9%, p=0.012, respectively), while there was no statistically significant difference in COVID-19 mortality between both groups (0% vs. 2.3%, p=0.124).These real-world data further support that outpatient treatment with monoclonal antibodies such as tixagevimab/cilgavimab can prevent clinical deterioration in kidney transplant recipients during a period of Omicron dominance. Novel therapeutics are needed for variants for which tixagevimab/cilgavimab shows no neutralization.
Keywords: COVID-19, COVID-19 drug treatment, Kidney Transplantation, Immunocompromised Host, Observational study
Received: 18 Feb 2025; Accepted: 21 May 2025.
Copyright: © 2025 Osmanodja, Bachmann, Choi, Duettmann, Eleftheriadis, Halleck, Naik, Schrezenmeier, Zukunft and Budde. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bilgin Osmanodja, Department of Nephrology and Medical Intensive Care, Charité University Medicine Berlin, Berlin, Germany
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