COVID‐19 therapeutics and outcomes among solid organ transplant recipients during the Omicron BA.1 era

Treatment outcomes associated with the use of novel COVID‐19 therapeutics in solid organ transplant recipients (SOTR) are not well described in the literature. The objective of this analysis was to characterize 30‐day hospitalization and other key secondary endpoints experienced by outpatient SOTR with mild–moderate COVID‐19 treated with nirmatrelvir/ritonavir (NR), sotrovimab, or no SARS‐CoV‐2 specific treatment. This IRB‐approved, retrospective study included 154 SOTR with a documented positive SARS‐CoV‐2 infection between December 16, 2021 and January 19, 2022 (a predominant Omicron BA.1 period in New York City). Patients who received NR (N = 28) or sotrovimab (N = 51) experienced a lower rate of 30‐day hospitalization or death as compared to those who received no specific treatment (N = 75) (p = .009). A total of three deaths occurred, all among patients who initially received no specific treatment prior to hospitalization. These results suggest a role for SARS‐CoV‐2 specific agents in the treatment of SOTR with COVID‐19, and that there does not appear to be any difference in effectiveness when comparing NR versus sotrovimab. This retrospective single‐center study of solid organ transplant recipients during the Omicron BA.1 era shows that treatment with nirmatrelvir/ritonavir or sotrovimab, compared to no SARS‐CoV2‐specific treatment, is associated with a lower incidence of 30‐day hospitalization or death.