We demonstrate that an early infusion of MoAb reduces the risk of severe COVID-19 having a 10-fold lesser risk of admission to ICUs and death and, consequently, strongly comforts preliminary results reported in SOT recipients without major side effects.11, 12, 13 This remarkable effectiveness of MoAb is the result of the strong potency of antispike MoAb to limit the spread of the virus in the first stage of the infection. 377) and those with a negative real-time polymerase chain reaction test result (8) and then with bamlanivimab-etesevimab (39) or casirivimab-imdevimab (33) (Number?2 ). The mean delay between the 1st symptoms and the administration of MoAb was 3.8 2.4 days with 6 individuals treated beyond the Ramipril fifth day time. Open in a separate window Figure?2 Use of antiCSARS-Cov-2 therapeutic antibodies between February 2021 and June 2021. The number of individuals treated with bamlanivimab as monotherapy (8), bamlanivimab-etesevimab (39), or casirivimab-imdevimab (33) is definitely displayed by month. The coordinating process recognized 155 control individuals among 1094 individuals included from your COVID-SFT registry. Their basal characteristics were compared with those of individuals treated with MoAb (Table?1 Ramipril ). As expected, no significant variations were observed concerning age, immunosuppressive routine, delay of transplantation, and comorbidities. Of notice, the proportion of asymptomatic KTRs was reduced the MoAb group than in the control group (1.3% vs. 21.3%, 80)155)value(%)45 (56.3)90 (58)0.889Age, median (IQR)57 (46C64.5)57 (44C65)0.940Age 60 yr, (%)34 (43)65 (42)0.999BMI (kg/m2), median (IQR)26.1 (23.7C30.1)27 (23.4C30)0.952Time from transplantation to COVID-19 (mo), median (IQR)57 (17C139)64 (21C140)0.521COVID-19 during the 1st post-transplant yr, (%)15 (18.8)26 (16.8)0.719First Ramipril transplantation, (%)67 (83.8)142 (91.6)0.081Combined transplantation, (%)4 (5)6 (3.9)0.999Living donor, (%)15 (18.8)23 (14.8)0.458T-cell depletion, (%)42 (52.5)87 (56.1)0.776Comorbidities, (%)?Diabetes mellitus27 (33.8)50 (32.3)0.884?Cardiac disease21 (26.3)38 (24.5)0.874?Hypertension62 (77.5)127 (81.9)0.488?Malignancy10 (12.5)26 (16.8)0.448?Respiratory disease11 (13.8)24 (15.5)0.847?BMI? 30 kg/m220 (25)42 (27.1)0.757?Quantity1.9 1.32.0 1.20.688Tobacco use, (%)8 (10)18 (11.6)0.423Symptoms, (%)?None1 (1.3)31 (21.3) 0.001?Dyspnea11 (13.8)28 (18.1)0.462?Fever34 (42.5)57 (36.8)0.400?Headache22 (27.5)29 (18.7)0.135?Myalgia26 (32.5)28 (18.9)0.033?Cough45 (56.3)70 (45.2)0.130?Diarrhea20 (25)45 (29)0.542?Vomiting3 (3.8)9 (6.2)0.546Immunosuppression, (%)?Calcineurin inhibitor71 (88.8)141 (91)0.645?Mycophenolic acid60 (75)110 (71)0.542?Azathioprine4 (5)13 (8.4)0.432?mTOR inhibitor13 (16.3)26 (16.8)0.999?Belatacept4 (5)3 (1.9)0.233?Steroids62 (77.5)119 Ramipril (76.8)0.999Suspension of immunosuppression, (%)?Calcineurin inhibitor4 (5.6)18 (13.5)0.083?Mycophenolic acid/azathioprine27 (42.2)47 (38.2)0.598?mTOR inhibitor6 (46.2)14 (53.9)0.651Vaccinated33 (44.2)0 (0.0) 0.0001Creatinine level at baseline before COVID-19 (mol/l), med (IQR)125 (100C165)130 (100C174)0.699 Open in a separate window BMI, body mass index, IQR, interquartile range, MoAb, monoclonal antibody; mTOR, mammalian target of rapamycin. Bold data indicate significant difference. Concerning immunosuppressive therapy management after analysis of COVID-19, we found that a slight majority of KTRs (126, 53.6%) underwent a reduction of their immunosuppression (MoAb: 39 [48.8%] vs. settings: 87 [58.0%], 7). Finally, the unique clinically relevant difference between the organizations concerned vaccination. Indeed, because vaccination was not yet available in 2020, no patient in the control group was vaccinated. In contrast, 33 KTRs (44.2%) treated with MoAb had received at least 1 dose of vaccine (1 dose: 17, 2 doses: 19, 3 doses: 3). Antispike protein antibodies before MoAb injection were detected in only 10 individuals. Patient Results In the 1st month, KTRs were less regularly hospitalized for worsening COVID-19 in the MoAb group than in the control group (28 [35.0%] vs. 77 Tmem33 [49.7%], 80)155)value(%)3 (3.8)30 (19.4)0.001Admission to ICU, (%)2 (2.5)24 (15.5)0.002Need for mechanical air flow, (%)0 (0.0)18 (11.6) 0.001Death, (%)1 (1.25)18 (11.6)0.005 Open in a separate window ICU, intensive care unit. Only 1 1 death (1.25%) occurred after administration of MoAb. It happened inside a 76-year-old male patient with several comorbidities and advanced vascular dementia disqualified for ICU admission. COVID-19 was diagnosed 10 years after the transplantation while the patient had already been hospitalized for misunderstandings (SARS-CoV-2 bad result on admission) in the context of a cluster recently developed in the unit. The early injection of a bamlanivimab-etesevimab combination 1 day after the first symptoms did not prevent the worsening of COVID-19 having a severe respiratory disease leading to death 5 days later on. The mortality in the control group was higher with 21 deaths (13.6%) notified during the follow-up (Number?3 ). Of 21 deaths, 18 (85.7%) occurred in the.