Effectiveness of Evusheld (Tixagevimab/Cilgavimab) in Reducing Breakthrough COVID-19 Infections Among Vaccinated Kidney Transplant Recipients
Bibliographic record
Abstract
Background: Transplant patients are at high risk of COVID-19 infection and its complications. Up to 33% of transplant patients have inappropriate response to COVID-19 vaccination with 2% mortality risk. Studies showed significant reduction with breakthrough COVID-19 infection post Evusheld administration. An Evusheld Clinic was launched at our center, in late July 2022, to facilitate the Evusheld administration to our kidney transplant patients. The aim of this study was to evaluate the efficacy of Evusheld pre-exposure prophylaxis preventing breakthrough COVID-19 infection among vaccinated kidney transplant patients in a single center study. Methods: We conducted a retrospective analysis of all kidney transplant patients at our center with breakthrough COVID-19 infection post-Evusheld administration between August 1, 2022 and January 6, 2023. Chi square and Fisher Exact test were performed using SPSS Statistics 23 with a 0.05 significance value. Results: 217 patients were included (Male: 66.8%; Age: 56.9±14.2years). 127 (58.5%) patients received Evusheld 300 mg through our clinic between August 1 - November 30, 2022. By January 6, 2023, 27 (12.4%) patients developed breakthrough infection since August 1, 2022, compared with a total of 76 (35.9%) COVID-19 infections since the pandemic in March 2020. 19 (15%) breakthrough infections were reported post-Evusheld administration compared with 8 (9%) cases in patients who did not receive Evusheld (P=0.18). All Evusheld patients with breakthrough infections were fully vaccinated (3 vaccine doses) compared with 75% of those with no Evusheld and breakthrough infections (P=0.08). Time from the last COVID-19 vaccination to infection was not significantly different among patients with and without Evusheld [4.6 (0.5-8.8) vs. 6.5 (92-8-10.6); P=0.46]. Conclusions: Evusheld 300 mg did not decrease the risk of breakthrough COVID-19 infection among fully vaccinated kidney transplant patients. Studies with higher doses of Evusheld and further COVID-19 vaccination are still required to determine efficacy of prevention of breakthrough COVID-19 infection among transplant patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".