After a lung transplant, preventive treatment with specific antibodies can reduce the risk of infection with SARS-CoV-2. Scientists at the DZL sites in Munich and Hanover discovered this.
The risk of severe coronavirus disease (COVID-19) is increased for recipients after a lung transplant. The best protection against a severe COVID-19 infection is vaccination. However, immunisation is often ineffective for recipients of solid donor organs, such as lungs.
Scientists at the two DZL sites in Munich and Hanover have discovered that prophylactic treatment of patients with two so-called monoclonal antibodies protects against SARS-CoV-2 infection.
To this end, they analysed 1,438 patients who had undergone a lung transplant in a study. Twenty-nine per cent of them received pre-exposure prophylaxis (PrEP) with the two monoclonal antibodies Tixagevimab and Cilgavimab. Both are SARS-CoV-2-neutralising antibodies derived from antibodies from people infected with the coronavirus.
Possibly also protection against severe progression
Patients received such PrEP either based on the individual decision of the treating doctor, for example, if they had concomitant diseases, were older or because they had not produced sufficient antibodies after being vaccinated against SARS-Cov-2.
There were, therefore, more high-risk patients in the group that took PrEP. If someone became infected with the coronavirus despite taking PrEP, the course of COVID-19 was similar to that of people who did not take PrEP. The study's authors believe that this shows that PrEP not only protects against infection but also helps ensure that the disease is not as severe in the event of an infection. This is because they had expected people in the PrEP group to have more severe courses of COVID-19. After all, they were at higher risk.
Original publication: Gottlieb J, Simon S, Barton J, et al. Efficacy of pre-exposure prophylaxis to prevent SARS-CoV-2 infection after lung transplantation: a two-centre cohort study during the omicron era. Infection. 2023;51(5):1481-1489. doi: 10.1007/s15010-023-02018-7
