Revolutionary Defense: Evusheld Triumphs in Combating Post Covid-ILD Among Liver and Kidney Transplant Recipients

Document Type

Conference Proceeding

Publication Date

10-25-2023

Publication Title

Am J Gastroenterol

Abstract

Introduction: The COVID-19 pandemic has not only caused immediate morbidity and mortality but has also been linked to residual chronic cardio-pulmonary sequelae. Literature shows that patients with severe COVID-19 pneumonia have a higher risk of developing interstitial lung disease (ILD) and chronic pulmonary vascular disease, with Idiopathic Pulmonary Fibrosis being most closely associated with the pandemic. This devastating condition leads to a severe decline in lung function, respiratory failure, and eventually death unless rescued by lung transplantation. To optimize post-discharge care of COVID-19 patients, this study aimed to investigate the outcomes of Evusheld use in post-liver, kidney, or dual transplant population, including the incidence of post-COVID-19 ILD. Methods: This retrospective chart review study was conducted at a tertiary care center from 2022 to 2023. Adult patients (age > 18 years) who received Evusheld after liver, kidney, or simultaneous liver-kidney transplant were included. Demographics, disease characteristics, and outcomes were recorded in de-identified datasheets. The primary outcome measured was the incidence of positive COVID-19 PCR tests. Secondary outcomes included the progression to interstitial lung disease (ILD), mechanical ventilation rate, and hospitalization rate. Univariate analyses utilized the Wilcoxon rank sum test, Pearson's Chi-squared test, Fisher's exact test, and Wilcoxon rank sum exact test. Results: Among 1,151 solid organ transplant recipients, 273 (23.7%) were diagnosed with COVID-19 between the start of the pandemic and February 2023. Among these, 1,019 (88.5%) were offered Evusheld, and 379 (37.2%) received at least 1 dose of Evusheld during the period from 2022 to 2023. Out of these, 118 patients were evaluated for ILD. In total, 8 (6.7%) patients showed sequelae of post-COVID-19 ILD. None of these patients had received Evusheld prior to the COVID-19 infection (P < 0.05). Additionally, there was no significant difference in the rate of hospitalization, the need for mechanical ventilation, and the number of days spent in the intensive care unit. Conclusion: Our results suggest that Evusheld was protective against post-COVID-19 ILD in all patients who received the infusion. The study is crucial, as it offers insight into the currently evolving care of COVID-19 survivors. Further randomized control trials are needed to understand the benefit of protective antibodies to COVID-19 in preventing post-COVID-19 ILD in transplant patients.

Volume

118

Issue

10

First Page

S1075

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