Evusheld 在免疫功能低下患者中预防 COVID-19 的真实世界评价：一项观察性队列研究

Evusheld , a combination of monoclonal antibodies Tixagevimab and Cilgavimab, was developed for pre-exposure prophylaxis (PrEP) of coronavirus disease 2019 (COVID-19) in immunocompromised patients. However, real-world long-term data on its effectiveness against SARS-CoV-2 Omicron variants remain limited.

A retrospective cohort was conducted on patients 18 years old who received the Evusheld from December 1, 2021, to January 31, 2023, at six Ascension hospitals in Southeast Michigan. Patients included were those with active solid tumor and hematologic malignancies or undergoing immunosuppressive treatment, including CAR-T therapy, biologic agents, or high-dose corticosteroids ( 20 mg prednisone or equivalent per day for 2 weeks). Data collected included patient demographics, development of COVID-19 post-Evusheld, ICU length of stay (LOS), hospital LOS, ventilation requirement and duration, and mortality within six months post-therapy.

Among 663 patients screened, 316 were included after excluding duplicates and patients that did not receive the ordered Evusheld regimen. Among them, 204 patients received two doses of Evusheld and 112 received only one dose. In the two-dose group, 18 (8.8%) tested positive for COVID-19 within 180 days post-Evusheld, while 11 (9.8%) in the one-dose group tested positive. Notably, none of the COVID-positive patients in either group required hospitalization, mechanical ventilation, or succumbed to the disease.

Within six months of Evusheld administration, immunocompromised patients showed no episodes of rehospitalization, mechanical ventilation, or death, and experienced low rates of severe COVID-19.