REAL WORLD EXPERIENCE OF SOTROVIMAB IN RENAL TRANSPLANT RECIPIENTS WITH MILD-MODERATE COVID-19 INFECTION

Dr Daniel Hirsch¹, Dr Vithoo Sivanathan¹, Dr Stella McGinn¹, Dr Yan Li¹

¹Department of Nephrology, Royal North Shore Hospital , Sydney, Australia

Aim: To explore the safety and efficacy of Sotrovimab in renal transplant recipients with mild-moderate COVID-19 infection.

Background: Renal transplant recipients are at high risk of developing severe COVID-19 infection. Sotrovimab is a monoclonal antibody against the COVID-19 spike protein that was briefly approved for use in Australia. It’s efficacy and safety in renal transplant recipients during this time is unclear.

Methods: Retrospective audit of electronic medical records, with a follow-up phone interview at least 2 months post infection, using a standardised questionnaire.

Results: Between December 2021 and March 2022, 18 renal transplant recipients tested positive for COVID-19 and received Sotrovimab within 5 days of infection. Questionnaire data was obtained for 17 patients. The median age was 50 years, 39% were female, 79% were Caucasian, the median time post-transplant was 86 months and 89% had received at least 2 doses of COVID-19 vaccine. The most common symptoms were fatigue (76%), headache (65%) and cough (65%). Immune suppression was reduced pre-emptively in 5 patients. One patient experienced dizziness, headache and diarrhoea attributed to Sotrovimab. There were no other adverse events. The 30-day hospitalisation rate was 28% (n=5), with 17% (n=3) admitted due to COVID-19 illness. All 3 were male, double vaccinated and 2 required supplemental oxygen. There were no ICU admissions. The 30-day mortality was 0%. At follow up, 35% of patients had ongoing symptoms with fatigue being the most common (18%), then dyspnoea (12%) and ‘brain-fog’ (12%). There were no rejection episodes.

Conclusions: In this cohort, Sotrovimab was safe and no patients progressed to severe disease. However, the hospitalisation rate was high and a third of patients had symptoms beyond 2 months.

Biography:

Daniel is a Renal Trainee at Department of Nephrology, Royal North Shore Hospital, Sydney.