Sonsoles Salto-Alejandre, Willa Cochran, Zishan Siddiqui, Julie Langlee, Lauren Boyer, Kristin Freed, Sophia Purekal, Ishaan Gupta, Mary Grace Bowring, Daniel C Brennan, William Werbel, Robin K Avery
{"title":"贝特罗单抗治疗时机对非卧床实体器官移植受者 COVID-19 结局的影响","authors":"Sonsoles Salto-Alejandre, Willa Cochran, Zishan Siddiqui, Julie Langlee, Lauren Boyer, Kristin Freed, Sophia Purekal, Ishaan Gupta, Mary Grace Bowring, Daniel C Brennan, William Werbel, Robin K Avery","doi":"10.1111/tid.14405","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Outcomes after bebtelovimab treatment for COVID-19 were favorable for most but not all solid organ transplant recipients (SOTRs) during the era of Omicron BA.2 to BA.5, but effects of timing of bebtelovimab administration on these outcomes are unknown. We sought to compare outcomes of SOTR who received early bebtelovimab (\"EBT\", given ≤ 2 days from diagnosis) versus late bebtelovimab (\"LBT\", given between Days 3 and 7), versus no bebtelovimab (NBT).</p><p><strong>Methods: </strong>This was a retrospective cohort study of SOTRs with mild-to-moderate COVID-19, with endpoint of 30-day COVID-19-related hospitalization. Multivariable logistic regression was performed to determine variables associated with receiving EBT, and to assess impact of EBT on hospitalization. A propensity score (PS) was calculated for EBT versus NBT.</p><p><strong>Results: </strong>Of 297 SOTRs, 162 (58.1%) received EBT, 46 (16.5%) LBT, and 71 (25.4%) NBT. Early bebtelovimab treatment was associated with a lower risk of 30-day COVID-19-related hospitalization compared to NBT (OR, 0.112 [95% CI, 0.018-0.686]; p = 0.018). There was no significant difference in hospitalization risk between LBT and NBT, suggesting that delayed administration may not confer additional benefits over no treatment.</p><p><strong>Conclusions: </strong>Early bebtelovimab treatment in outpatient SOTRs was associated with a lower risk of hospitalization compared to no treatment, while late administration did not show a significant advantage over no treatment. Although bebtelovimab is no longer authorized, these findings suggest that the timing of COVID therapies for SOTRs may be important to optimize outcomes.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14405"},"PeriodicalIF":2.6000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Bebtelovimab Treatment Timing on COVID-19 Outcomes in Ambulatory Solid Organ Transplant Recipients.\",\"authors\":\"Sonsoles Salto-Alejandre, Willa Cochran, Zishan Siddiqui, Julie Langlee, Lauren Boyer, Kristin Freed, Sophia Purekal, Ishaan Gupta, Mary Grace Bowring, Daniel C Brennan, William Werbel, Robin K Avery\",\"doi\":\"10.1111/tid.14405\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Outcomes after bebtelovimab treatment for COVID-19 were favorable for most but not all solid organ transplant recipients (SOTRs) during the era of Omicron BA.2 to BA.5, but effects of timing of bebtelovimab administration on these outcomes are unknown. We sought to compare outcomes of SOTR who received early bebtelovimab (\\\"EBT\\\", given ≤ 2 days from diagnosis) versus late bebtelovimab (\\\"LBT\\\", given between Days 3 and 7), versus no bebtelovimab (NBT).</p><p><strong>Methods: </strong>This was a retrospective cohort study of SOTRs with mild-to-moderate COVID-19, with endpoint of 30-day COVID-19-related hospitalization. Multivariable logistic regression was performed to determine variables associated with receiving EBT, and to assess impact of EBT on hospitalization. A propensity score (PS) was calculated for EBT versus NBT.</p><p><strong>Results: </strong>Of 297 SOTRs, 162 (58.1%) received EBT, 46 (16.5%) LBT, and 71 (25.4%) NBT. Early bebtelovimab treatment was associated with a lower risk of 30-day COVID-19-related hospitalization compared to NBT (OR, 0.112 [95% CI, 0.018-0.686]; p = 0.018). There was no significant difference in hospitalization risk between LBT and NBT, suggesting that delayed administration may not confer additional benefits over no treatment.</p><p><strong>Conclusions: </strong>Early bebtelovimab treatment in outpatient SOTRs was associated with a lower risk of hospitalization compared to no treatment, while late administration did not show a significant advantage over no treatment. Although bebtelovimab is no longer authorized, these findings suggest that the timing of COVID therapies for SOTRs may be important to optimize outcomes.</p>\",\"PeriodicalId\":23318,\"journal\":{\"name\":\"Transplant Infectious Disease\",\"volume\":\" \",\"pages\":\"e14405\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-11-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplant Infectious Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/tid.14405\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant Infectious Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tid.14405","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Impact of Bebtelovimab Treatment Timing on COVID-19 Outcomes in Ambulatory Solid Organ Transplant Recipients.
Background: Outcomes after bebtelovimab treatment for COVID-19 were favorable for most but not all solid organ transplant recipients (SOTRs) during the era of Omicron BA.2 to BA.5, but effects of timing of bebtelovimab administration on these outcomes are unknown. We sought to compare outcomes of SOTR who received early bebtelovimab ("EBT", given ≤ 2 days from diagnosis) versus late bebtelovimab ("LBT", given between Days 3 and 7), versus no bebtelovimab (NBT).
Methods: This was a retrospective cohort study of SOTRs with mild-to-moderate COVID-19, with endpoint of 30-day COVID-19-related hospitalization. Multivariable logistic regression was performed to determine variables associated with receiving EBT, and to assess impact of EBT on hospitalization. A propensity score (PS) was calculated for EBT versus NBT.
Results: Of 297 SOTRs, 162 (58.1%) received EBT, 46 (16.5%) LBT, and 71 (25.4%) NBT. Early bebtelovimab treatment was associated with a lower risk of 30-day COVID-19-related hospitalization compared to NBT (OR, 0.112 [95% CI, 0.018-0.686]; p = 0.018). There was no significant difference in hospitalization risk between LBT and NBT, suggesting that delayed administration may not confer additional benefits over no treatment.
Conclusions: Early bebtelovimab treatment in outpatient SOTRs was associated with a lower risk of hospitalization compared to no treatment, while late administration did not show a significant advantage over no treatment. Although bebtelovimab is no longer authorized, these findings suggest that the timing of COVID therapies for SOTRs may be important to optimize outcomes.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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