International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Clinical outcomes of immunocompromised patients administered tixagevimab-cilgavimab as pre-exposure prophylaxis for COVID-19: Real-world experience in Taiwan.
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Ho Yu-Chien, Wang Yi-Ting, Chou Sheng-Hua, Liu Szu-Yu, Chuang Chien, Chin Wan, Ho Hsiang-Ling, Lin Yi-Tsung
Аннотация
OBJECTIVES: Immunocompromised patients with COVID-19 are at a higher risk of hospitalization and death. Low seroconversion rate after COVID-19 vaccination are common in immunocompromised patients. Evusheld, a combination of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies tixagevimab-cilgavimab, was previously recommended as COVID-19 pre-exposure prophylaxis for immunocompromised patients. Our study aimed to present the real-world experience of tixagevimab-cilgavimab use in Taiwan.
METHODS: Adults who received tixagevimab-cilgavimab at the Taipei Veterans General Hospital during October 2022-June 2023 were identified. The main outcomes were SARS-CoV-2 infection, severe or critical COVID-19, and the 6-month all-cause mortality rate. Multivariate Cox regression analysis was performed to identify factors associated with poor outcomes.
RESULTS: Overall, 352 adult patients received tixagevimab-cilgavimab. The common indications were hematological malignancies (84.1%), autoimmune disease (10.5%), solid organ transplantation (4.8%), and the presence of solid tumors under treatment (4.5%). During the 6-month follow-up, 39 patients (11.1%) test COVID-19 positive, including 29 (8.2%) and 10 (2.8%) who developed mild-to-moderate and severe or critical COVID-19, respectively. The overall 6-month all-cause mortality rate was 4.8%. In patients with COVID-19, the corresponding rate was 1.1%. Age ≥ 70 years (P = 0.038) and the presence of solid tumors under treatment (P = 0.033) were independent risk factors for severe or critical COVID-19.
CONCLUSION: Tixagevimab/cilgavimab -treated immunocompromised patients had a low rate of subsequent severe or critical COVID-19. Our study provides insights into the role of future monoclonal antibodies as COVID-19 pre-exposure prophylaxis among immunocompromised patients and emphasizes the need for ongoing research.
METHODS: Adults who received tixagevimab-cilgavimab at the Taipei Veterans General Hospital during October 2022-June 2023 were identified. The main outcomes were SARS-CoV-2 infection, severe or critical COVID-19, and the 6-month all-cause mortality rate. Multivariate Cox regression analysis was performed to identify factors associated with poor outcomes.
RESULTS: Overall, 352 adult patients received tixagevimab-cilgavimab. The common indications were hematological malignancies (84.1%), autoimmune disease (10.5%), solid organ transplantation (4.8%), and the presence of solid tumors under treatment (4.5%). During the 6-month follow-up, 39 patients (11.1%) test COVID-19 positive, including 29 (8.2%) and 10 (2.8%) who developed mild-to-moderate and severe or critical COVID-19, respectively. The overall 6-month all-cause mortality rate was 4.8%. In patients with COVID-19, the corresponding rate was 1.1%. Age ≥ 70 years (P = 0.038) and the presence of solid tumors under treatment (P = 0.033) were independent risk factors for severe or critical COVID-19.
CONCLUSION: Tixagevimab/cilgavimab -treated immunocompromised patients had a low rate of subsequent severe or critical COVID-19. Our study provides insights into the role of future monoclonal antibodies as COVID-19 pre-exposure prophylaxis among immunocompromised patients and emphasizes the need for ongoing research.