The prevention of COVID-19 in high-risk patients using tixagevimab–cilgavimab (Evusheld): Real-world experience at a large academic center

Abstract

Background

Coronavirus disease (COVID-19) is associated with increased morbidity and mortality among immunocompromised patients. Tixagevimab–Cilgavimab (Tix-Cil) is a combination of two monoclonal antibodies approved for the prevention of COVID-19 complications in this high-risk group.

Methods

We retrospectively reviewed the charts of patients who received Tix-Cil during the Omicron variant period (January 17 to April 23, 2022), with a follow-up period until May 24, 2022. We collected data regarding patient underlying comorbidities and post Tix-Cil COVID-19 infections, deaths, and hospitalizations.

Results

There were 463 patients with a median age of 68, of which 51% were male, 79% White, 13.2% Hispanic, 1.7% Black/African American, and 5.8% who identified as Other. A total of 18% had undergone a solid organ transplantation (SOT) or Hematopoietic Stem Cell Transplantation (HSCT). Only 6/98 (6.1%) had a SARS-CoV-2 detected by PCR at a median 48 days (IQR 27.5, 69) follow-up. Forty-two patients (9.1%) were hospitalized, and four (0.9%) died, but none were attributed to COVID-19 or Tix-Cil. One hospitalized patient had an incidental, asymptomatic, positive SARS-CoV 2 by PCR. The median days from Tix-Cil administration to non-COVID-19 related hospitalization and death were 30 (IQR 17, 55) and 53 (IQR 18, 91), respectively.

Conclusion

Tix-Cil provides protection against COVID-19 complications in immunocompromised patients with suboptimal immune responses to vaccines.