INCIDENCE OF COVID-19 INFECTIONS IN ADULTS WITH PRIMARY IMMUNODEFICIENCY AFTER RECEIVING TIXAGEVIMAB AND CILGAVIMAB

INTRODUCTION: Individuals with a primary immunodeficiency are at an increased risk of developing SARS-CoV-2 infection. Tixagevimab and cilgavimab is a neutralizing long-acting monoclonal antibody that has been shown to prevent SARS-CoV-2 infection. However, there has been limited data on the efficacy in patients with primary immunodeficiency. METHODS: A retrospective cohort study was conducted comparing 79 adults with a primary immunodeficiency who received tixagevimab and cilgavimab to 79 randomly selected adults with primary immunodeficiency who did not receive tixagevimab and cilgavimab at a tertiary referral center. The incidence of SARS-CoV-2 infections and associated hospitalization rates from January 2022 to June 2022 were compared using the chi-square test. RESULTS: The distribution of immunodeficiencies in the treatment and control groups were as follows: Common Variable Immunodeficiency (CVID) (70 vs 65), B-cell depleting therapy (6 vs 2), specific antibody deficiency (2 vs 12), and idiopathic CD4+ lymphocytopenia (1 vs 0). SARS-CoV-2 infections occurred in 8 (10%) individuals in the treatment group and in 9 (11%) individuals in the control group (p= 0.80). All individuals who tested positive for SARS-CoV-2 were symptomatic. No individuals were hospitalized in the treatment group compared to 2 individuals in the control group (p= 0.15). CONCLUSION: There was no significance difference in the incidence of SARS-CoV-2 infection in adults with primary Immunodeficiency who received Tixagevimab and Cilgavimab compared to those who did not. While there was also no significant difference in incidence of hospitalization for SARS-CoV-2 infection, it is important to note that there were no hospitalizations in patients who received Tixagevimab and Cilgavimab.