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In Reply to ‘Kidney Transplant Recipients With COVID-19 and Monoclonal Antibody Therapy: Additional Considerations’

Open AccessPublished:June 23, 2022DOI:https://doi.org/10.1016/j.xkme.2022.100503
      We thank Mungmunpuntipantip and Wiwanitkit
      • Mungmunpuntipantip R.
      • Wiwanitkit V.
      Kidney transplant recipients with COVID-19 and monoclonal antibody therapy: additional considerations [letter].
      for their constructive comments. Among the 47 kidney transplant recipients included in this study, 17 had antihuman leukocyte antigen antibodies detected within 2 years prior to infection, but none had donor-specific antibodies.
      • Fernandes G.
      • Devresse A.
      • Scohy A.
      • et al.
      Monoclonal antibody therapy in kidney transplant recipients with delta and omicron variants of SARS-CoV-2: a single-center case series.
      Antihuman leukocyte antigen antibody status was not available for 6 patients. No patient was treated for acute rejection in the 2 years prior to infection.
      Eight kidney transplant recipients out of 47 had a history of documented SARS-CoV-2 infection. Among them, only 3 presented with positive antinucleocapside antibodies. Interestingly, 2 additional patients in the cohort had positive antinucleocapside antibodies without any prior documented infection. None of these kidney transplant recipients required hospitalization.
      We agree that this may have played a role in these patients’ recoveries as prior infection may reduce the risk of severe COVID-19.
      • Hall V.
      • Foulkes S.
      • Insalata F.
      • et al.
      Protection against SARS-CoV-2 after Covid-19 vaccination and previous infection.
      ,
      • Nordström P.
      • Ballin M.
      • Nordström A.
      Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden.
      However, our cohort is too limited to draw conclusions on this. Moreover, to our knowledge, it is ill-defined whether prior infection that does not lead to a serologic response confers protection against severe COVID-19.

      Article Information

      Authors’ Contributions

      Drs Fernandes and Devresse contributed equally to this correspondence.

      Financial Disclosure

      The authors declare that they have no relevant financial interests.

      Peer Review

      Received May 25, 2022 in response to an invitation from the journal. Accepted June 03, 2022 after editorial review by the Editor-in-Chief.

      References

        • Mungmunpuntipantip R.
        • Wiwanitkit V.
        Kidney transplant recipients with COVID-19 and monoclonal antibody therapy: additional considerations [letter].
        Kidney Med. 2022; 4: 100502
        • Fernandes G.
        • Devresse A.
        • Scohy A.
        • et al.
        Monoclonal antibody therapy in kidney transplant recipients with delta and omicron variants of SARS-CoV-2: a single-center case series.
        Kidney Med. 2022; 4100470https://doi.org/10.1016/j.xkme.2022.100470
        • Hall V.
        • Foulkes S.
        • Insalata F.
        • et al.
        Protection against SARS-CoV-2 after Covid-19 vaccination and previous infection.
        N Engl J Med. 2022; 386: 1207-1220
        • Nordström P.
        • Ballin M.
        • Nordström A.
        Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden.
        Lancet Infect Dis. 2022; 22: 781-790https://doi.org/10.1016/S1473-3099(22)00143-8

      Linked Article

      • Kidney Transplant Recipients With COVID-19 and Monoclonal Antibody Therapy: Additional Considerations
        Kidney MedicineVol. 4Issue 8
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          We read with interest the recent article in which Fernandes et al1 found that neutralizing monoclonal antibody therapy was associated with favorable outcomes among kidney transplant recipients presenting with mild COVID-19. We agree that neutralizing monoclonal antibody treatment may be beneficial. However, we highlight that additional information on patients’ immunologic state would be useful, including recent receipt of other transplant immunosuppression and underlying health conditions that may impact the susceptibility to developing severe COVID-19.
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