Treatment of COVID-19 in Moderately or Severely Immunocompromised Patients with Increased Risk of Inadequate Vaccine Response
Patients who are moderately or severely immunocompromised may not mount an adequate immune response to standard COVID-19 vaccination. For these individuals — and for those in whom COVID-19 vaccination is contraindicated due to a documented serious adverse reaction — a dedicated pre-exposure prophylaxis approach is recommended.
Clinical scenario: Moderately or severely immunocompromised state with increased risk for inadequate immune response to COVID-19 vaccine; or documented serious adverse reaction to COVID-19 vaccine making vaccination not recommended.
Treatment approach
The structured protocol for this population involves pre-exposure prophylaxis with a specific monoclonal antibody combination, administered when predominant regional variants remain susceptible to the agent. Full eligibility criteria, sequencing, and administration details are available in the complete regimen.
Clinical goal
Absence of symptomatic COVID-19 infection within 6 months of administration.
References
- In moderately or severely immunocompromised individuals at increased risk for inadequate immune response to COVID-19 vaccine or for persons for whom COVID-19 vaccine is not recommended due to a documented serious adverse reaction to the vaccine, the IDSA guideline panel suggests pre-exposure prophylaxis with tixagevimab/cilgavimab rather than no tixagevimab/cilgavimab, when predominant regional variants are susceptible to the agent.
DOI: 10.1093/cid/ciac724
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