Organ transplant recipients may not mount an adequate immune response to COVID-19 infection and therefore may benefit greatly from passive immunization with anti-spike monoclonal antibodies (mAbs), which have been shown to decrease hospitalization rates in the general outpatient population. We evaluated the efficacy of mAb therapy in decreasing hospitalizations or emergency room (ER) visits among kidney transplant recipients (KTR) with COVID-19. We identified KTR with COVID-19 between March 1, 2020 and April 30, 2021. Patients were excluded if they had multi-organ transplant or hospital-acquired COVID-19. We studied 95 KTR; 20 received mAb. mAb administration was associated with a significant decrease in hospitalizations or ER visits (15% vs. 76%, p < 0.001). This association remained significant after adjustment for potential confounders, and analysis of mAb administration as a time-dependent variable, with day of symptom onset as day 1 (adjusted HR 0.216, p = 0.04). Black or Hispanic patients were less likely to receive mAb and more likely to be admitted to the hospital or visit the ER. In our KTR population, mAb therapy for COVID-19 may have helped decrease hospitalizations and ER visits. Healthcare inequities, including access to investigational treatments, have been exacerbated by the COVID-19 pandemic. Antiviral mAbs are a promising therapeutic modality, especially for immunocompromised patients.

中文翻译：

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在患有 COVID-19 的肾移植受者中使用抗尖峰单克隆抗体：疗效、种族和种族差异

器官移植受者可能无法对 COVID-19 感染产生足够的免疫反应，因此可能会从抗刺突单克隆抗体 (mAb) 的被动免疫中获益匪浅，这已被证明可以降低普通门诊患者的住院率。我们评估了 mAb 疗法在减少 COVID-19 肾移植受者 (KTR) 住院或急诊 (ER) 就诊方面的疗效。我们在 2020 年 3 月 1 日至 2021 年 4 月 30 日期间确定了 KTR 与 COVID-19。如果患者进行了多器官移植或医院获得性 COVID-19，则他们被排除在外。我们研究了 95 KTR；20 人接受了 mAb。mAb 给药与住院或急诊就诊的显着减少相关（15% 对 76%，p < 0.001)。在对潜在混杂因素进行调整后，这种关联仍然显着，并将 mAb 给药作为时间相关变量进行分析，症状发作日期为第 1 天（调整后的 HR 0.216，p = 0.04 ）  。黑人或西班牙裔患者不太可能接受 mAb，而更有可能住院或去急诊室。在我们的 KTR 人群中，针对 COVID-19 的单克隆抗体疗法可能有助于减少住院和急诊就诊。COVID-19 大流行加剧了医疗保健的不平等，包括获得研究性治疗的机会。抗病毒单克隆抗体是一种很有前途的治疗方式，尤其是对于免疫功能低下的患者。