Table 1.
Characteristics of kidney transplant recipients receiving sotrovimab and outcomes
| All | Recovered | Dead | ||
|---|---|---|---|---|
| Variable | (N = 82) | (n = 75) | (n = 7) | P-value |
| Males, n(%) | 44 (53.7) | 40 (53.3) | 4 (57.1) | >.99 |
| Recipient age, median (IQR), years | 63 (56–70) | 63 (56–69) | 72 (69–80) | .01 |
| Time after KT to COVID-19, median (IQR), monthsa | 47 (23–113) | 44 (22–111) | 52 (26–175) | .56 |
| Vaccination, n(%) | 76 (92.7) | 69 (92) | 7 (100) | >.99 |
| Number of doses of vaccine received | .58 |
|||
| Two doses, n(%) | 10 (13.2) | 10 (14.5) | 0 (0) | |
| Three doses, n(%) | 66 (86.8) | 59 (85.5) | 7 (100) | |
| Type of third dose of vaccine | .66 | |||
| mRNA-1273 Moderna, n(%) | 47 (69.1) | 43 (70.5) | 4 (57.1) | |
| BNT162b2 Pfizer-BioNTech, n(%) | 21 (30.9) | 18 (29.5) | 3 (42.9) | |
| SARS-CoV-2 IgG anti-S | .36 | |||
| Negative, n(%) | 74 (90.2) | 67 (89.3) | 7 (100) | |
| Positive (<100 BAU/mL), n(%) | 8 (9.8) | 8 (10.7) | 0 | |
| Baseline kidney graft function | ||||
| sCr, median (IQR), mg/dl | 1.9 (1.3–2.7) | 1.8 (1.3–2.6) | 2.8 (1.7–3.1) | .14 |
| ACR, median (IQR), mg/g | 37 (3–255) | 39 (2–250) | 35 (16–970) | .54 |
| eGFR, median (IQR), mL/minute/1.73 m2) | 31 (19–50) | 31.4 (19–52) | 20.7 (16–35.2) | .11 |
| eGFR 30–59 mL/minute/1.73 m2, n(%) | 31 (37.8) | 29 (38.7) | 2 (28.6) | .55 |
| eGFR 15–29 mL/minute/1.73 m2, n(%) | 34 (41.5) | 30 (40) | 4 (57.1) | |
| eGFR <15 mL/minute/1.73 m2, n(%) | 6 (7.3) | 5 (6.7) | 1 (14.3) | |
| Other comorbidities | ||||
| Recipient age >65 years, n(%) | 39 (47.6) | 33 (44) | 6 (85.7) | .04 |
| BMI >30 kg/m2, n(%) | 26 (32.9) | 23 (31.9) | 3 (42.9) | .67 |
| Hypertension, n(%) | 72 (87.8) | 65 (86.7) | 7 (100) | .58 |
| Diabetesb, n(%) | 36 (43.9) | 33 (44) | 3 (42.9) | >.99 |
| Cardiovascular disease, n(%) | 22 (26.8) | 17 (22.7) | 5 (71.4) | .01 |
| Cerebrovascular disease, n(%) | 7 (8.5) | 7 (9.3) | 0 (0) | .52 |
| Chronic liver disease, n(%) | 5 (6.1) | 5 (6.7) | 0 (0) | .63 |
| Chronic lung disease, n(%) | 13 (15.9) | 12 (16) | 1 (14.3) | >.99 |
| Active cancer, n(%) | 2 (2.4) | 2 (2.7) | 0 (0) | >.99 |
| CCI, median (IQR) | 5 (3–6) | 5 (3–6) | 8 (6.5–9) | .005 |
| Prior SARS-CoV-2 infection, n(%) | 3 (3.6) | 3 (4) | 0 | .59 |
| Immunosuppressive therapy at COVID-19 diagnosis | ||||
| Prednisone, n(%) | 67 (81.7) | 60 (80.0) | 7 (100) | .34 |
| Tacrolimus, n(%) | 79 (96.3) | 72 (91.1) | 7 (100) | >.99 |
| Tacrolimus through, ng/dL | 7.1 (6–8.7) | 7.1 (5.9–9.1) | 6.8 (6–8) | .75 |
| Mycophenolate, n(%) | 72 (87.8) | 65 (86.7) | 7 (100) | .58 |
| Mycophenolate >1000 mg/day, n(%) | 47 (65.2) | 43 (66.2) | 4 (57.1) | .63 |
| mTOR inhibitor, n(%) | 7 (8.5) | 7 (9.3) | 0 (0) | .52 |
| Cyclosporine, n(%) | 2 (2.4) | 2 (2.7) | 0 (0) | >.99 |
| Immunosuppressive therapy within 2 years before COVID-19 diagnosis | ||||
| Thymoglobulin, n(%) | 10 (12.2) | 10 (13.3) | 0 (0) | .58 |
| Basiliximab, n(%) | 6 (7.3) | 6 (8) | 0 (0) | .57 |
| Rituximab, n(%) | 2 (2.5) | 2 (2.7) | 0 (0) | >.99 |
| Clinical features | ||||
| Fever, n(%) | 49 (59.8) | 44 (58.7) | 5 (71.4) | .69 |
| Upper respiratory tract symptomsa, n(%) | 61 (74.4) | 55 (73.3) | 6 (85.7) | .67 |
| Gastrointestinal symptoms, n(%) | 28 (34.1) | 23 (30.7) | 5 (71.4) | .04 |
| Dyspnea, n(%) | 45 (54.9) | 38 (46.3) | 7 (100) | .01 |
| Oxygen saturation at admission <95%, n(%) | 35 (42.6) | 30 (40) | 5 (71.4) | .43 |
| Pneumonia, n(%) | 53 (64.6) | 46 (61.3) | 7 (100) | .04 |
| Lymphopenia, n(%) | 62 (76.5) | 56 (75.7) | 6 (85.7) | >.99 |
| Lymphocyte countb, median (IQR), (×103/µL) | 400 (200–540) | 400 (270–540) | 210 (112–315) | .05 |
| Time from onset of symptoms to sotrovimab infusion, median (IQR), days | 5 (2–10.2) | 4 (2–10) | 13 (10–22) | .003 |
| Time from onset of symptoms to sotrovimab infusion <5 days, n(%) | 46 (56.1) | 45 (60) | 1 (14.3) | .04 |
| Hospitalized, n(%) | 67 (81.7) | 60 (80) | 7 (100) | .34 |
| Additional COVID-19 therapy | ||||
| Glucocorticoids, n(%) | 54 (65.9) | 47 (62.7) | 7 (100) | .08 |
| Tocilizumab, n(%) | 17 (20.7) | 14 (18.7) | 3 (42.9) | .15 |
| Remdesivir, n(%) | 21 (25.6) | 20 (26.7) | 1 (14.3) | .67 |
| COVID-19 outcomes | ||||
| Ventilator support, n(%) | 14 (17.1) | 7 (9.3) | 7 (100) | <.001 |
| ICU admission, n(%) | 10 (12.2) | 7 (9.3) | 3 (42.9) | .03 |
ACR: albumin-to-creatinine ratio; BAU: binding antibody unit; BMI: body mass index; CCI, Charlson Comorbidity Index; COVID-19: coronavirus disease 2019; eGFR: estimated glomerular filtration rate; ICU: intensive care unit; IgG: immunoglobulin G; IQR: interquartile range; KT: kidney transplant; mTOR: mammalian target of rapamycin; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; sCr: serum creatinine.
aCough, sore throat, rhinorrhea, or expectoration.
bOnly included patients with lymphopenia.