Naser, Maryam

Abstract Introduction COVID-19 infection is associated with an increased risk of complications, prolonged hospitalization, and mortality despite vaccination in patients with cancer. Evusheld (tixagevimab-cilgavimab) was granted emergency use approval in December 2021 for pre-exposure prophylaxis based on preliminary results from the PROVENT trial. However, studies evaluating the impact of Evusheld in cancer patients in the real-world are limited. In this study, we assessed the impact of Evusheld on the incidence and severity of COVID-19 infection in cancer patients at our institution. Methods and Materials We conducted a retrospective descriptive study at our institution on patients with current and prior history of cancer diagnosis regardless of treatment history who received Evusheld between December 2021 and March 2022. The primary outcome was incidence of COVID-19 during a 6 month follow up period. Secondary outcomes included rate of hospitalization related to COVID-19 and associated mortality. Results A total of 228 patients were included, 43% of which received 2 doses of Evusheld during the study period. Twenty-nine patients (12.7%, 95% CI 9.4% – 18.7%) developed COVID-19, with an average time to diagnosis of 2.5 months (SD 1.6) from receiving Evusheld. Most had hematologic malignancies (68.4%) and were receiving active chemotherapy (71.5%) at the time of diagnosis. Five (17.2%) patients were hospitalized for COVID-19, of whom 4 had hematological malignancy. One patient with hematological malignancy required mechanical ventilation and died. Conclusion Overall, the incidence of COVID-19 following Evusheld was higher than in the PROVENT trial. Infections appeared to be more common and severe in patients with hematologic malignancies.