Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19

Abstract Background This meta-analysis addresses the efficacy and safety of tixagevimab-cilgavimab as pre-exposure prophylaxis against COVID-19 in immunocompromised patients, particularly during the Omicron variant surge. Given the limited vaccine response in this population, alternative prophylacti...

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Main Authors: Mostafa Hossam El Din Moawad, Abdallah Abbas, Haneen Sabet, Mohamed Ahmed Zanaty, Abdullah Ashraf Hamad, Ayoub Rezkallah, Osama Ballut, Taha Fayad, Mona Mahmoud Elsakka, Francis Eshun, Hussien Ahmed H. Abdelgawad
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Virology Journal
Online Access:https://doi.org/10.1186/s12985-025-02814-7
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author Mostafa Hossam El Din Moawad
Abdallah Abbas
Haneen Sabet
Mohamed Ahmed Zanaty
Abdullah Ashraf Hamad
Ayoub Rezkallah
Osama Ballut
Taha Fayad
Mona Mahmoud Elsakka
Francis Eshun
Hussien Ahmed H. Abdelgawad
author_facet Mostafa Hossam El Din Moawad
Abdallah Abbas
Haneen Sabet
Mohamed Ahmed Zanaty
Abdullah Ashraf Hamad
Ayoub Rezkallah
Osama Ballut
Taha Fayad
Mona Mahmoud Elsakka
Francis Eshun
Hussien Ahmed H. Abdelgawad
author_sort Mostafa Hossam El Din Moawad
collection DOAJ
description Abstract Background This meta-analysis addresses the efficacy and safety of tixagevimab-cilgavimab as pre-exposure prophylaxis against COVID-19 in immunocompromised patients, particularly during the Omicron variant surge. Given the limited vaccine response in this population, alternative prophylactic strategies are critical. Methods Following PRISMA guidelines, we comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and Embase, up to June 22, 2024. We included studies assessing tixagevimab-cilgavimab's impact on SARS-CoV-2 infection rates, hospitalization, ICU admissions, and/or mortality among immunocompromised patients. Data synthesis and analysis were conducted using RevMan and Open-Meta Analyst software. Results Analyzing data from 36 studies involving 28,950 patients, tixagevimab-cilgavimab significantly reduced SARS-CoV-2 infection rates by 4.37%, hospitalization by 0.8%, and mortality by 0.5%. Compared to no prophylaxis, the drug combination showed a notable reduction in SARS-CoV-2 infection (OR = 0.33, 95% CI: 0.22–0.50), hospitalization (OR = 0.24, 95% CI: 0.15–0.39), and mortality (OR = 0.33, 95% CI: 0.16–0.66), exhibiting a favorable safety and efficacy profile. During the Omicron surge, tixagevimab-cilgavimab consistently reduced infection risk (OR = 0.32, 95% CI: 0.17–0.58). Conclusion Tixagevimab-cilgavimab offers a significant protective effect against COVID-19, including Omicron variants, in immunocompromised patients, underscoring its role as an effective pre-exposure prophylaxis. Future studies should further explore its efficacy across different SARS-CoV-2 variants and potential synergies with vaccination efforts.
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spelling doaj-art-4b9d629b890549d5af3d35eba5250d402025-08-20T03:10:27ZengBMCVirology Journal1743-422X2025-06-0122111710.1186/s12985-025-02814-7Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19Mostafa Hossam El Din Moawad0Abdallah Abbas1Haneen Sabet2Mohamed Ahmed Zanaty3Abdullah Ashraf Hamad4Ayoub Rezkallah5Osama Ballut6Taha Fayad7Mona Mahmoud Elsakka8Francis Eshun9Hussien Ahmed H. Abdelgawad10Faculty of Pharmacy Clinical Department, Alexandria UniversityFaculty of Medicine, Al-Azhar UniversityFaculty of Medicine, South Valley UniversityFaculty of Medicine, South Valley UniversityFaculty of Medicine, Menoufia UniversityFaculty of Medicine, Algiers UniversityFaculty of Medicine, Kasr Alainy, Cairo UniversityFaculty of Oral and Dental Medicine, Sinai UniversityFaculty of Pharmacy, Damanhour UniversityCenter for Cancer and Blood Disorders, Phoenix Children’s HospitalCenter for Cancer and Blood Disorders, Phoenix Children’s HospitalAbstract Background This meta-analysis addresses the efficacy and safety of tixagevimab-cilgavimab as pre-exposure prophylaxis against COVID-19 in immunocompromised patients, particularly during the Omicron variant surge. Given the limited vaccine response in this population, alternative prophylactic strategies are critical. Methods Following PRISMA guidelines, we comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and Embase, up to June 22, 2024. We included studies assessing tixagevimab-cilgavimab's impact on SARS-CoV-2 infection rates, hospitalization, ICU admissions, and/or mortality among immunocompromised patients. Data synthesis and analysis were conducted using RevMan and Open-Meta Analyst software. Results Analyzing data from 36 studies involving 28,950 patients, tixagevimab-cilgavimab significantly reduced SARS-CoV-2 infection rates by 4.37%, hospitalization by 0.8%, and mortality by 0.5%. Compared to no prophylaxis, the drug combination showed a notable reduction in SARS-CoV-2 infection (OR = 0.33, 95% CI: 0.22–0.50), hospitalization (OR = 0.24, 95% CI: 0.15–0.39), and mortality (OR = 0.33, 95% CI: 0.16–0.66), exhibiting a favorable safety and efficacy profile. During the Omicron surge, tixagevimab-cilgavimab consistently reduced infection risk (OR = 0.32, 95% CI: 0.17–0.58). Conclusion Tixagevimab-cilgavimab offers a significant protective effect against COVID-19, including Omicron variants, in immunocompromised patients, underscoring its role as an effective pre-exposure prophylaxis. Future studies should further explore its efficacy across different SARS-CoV-2 variants and potential synergies with vaccination efforts.https://doi.org/10.1186/s12985-025-02814-7
spellingShingle Mostafa Hossam El Din Moawad
Abdallah Abbas
Haneen Sabet
Mohamed Ahmed Zanaty
Abdullah Ashraf Hamad
Ayoub Rezkallah
Osama Ballut
Taha Fayad
Mona Mahmoud Elsakka
Francis Eshun
Hussien Ahmed H. Abdelgawad
Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
Virology Journal
title Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
title_full Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
title_fullStr Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
title_full_unstemmed Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
title_short Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19
title_sort unveiling protection a meta analysis of tixagevimab cilgavimab prophylaxis in 28 950 transplant recipients and immunocompromised patients against covid 19
url https://doi.org/10.1186/s12985-025-02814-7
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