Effect of monoclonal antibody treatment on clinical outcomes in ambulatory patients with COVID-19

Abstract We compared rates of emergency department visits or hospitalizations among ambulatory COVID-19 patients treated with monoclonal antibody (mAb) therapy (n=305) versus untreated patients (n=6354). Treatment was associated with decreased encounters within 30 days (adjusted OR 0.23; 95%CI 0.15-0.36). Our findings support treatment of acute COVID-19 with mAb.

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Use of a Unique Mobile Medical Asset in COVID Monoclonal Antibody Treatment

Healthcare ◽

10.3390/healthcare9080990 ◽

2021 ◽

Vol 9 (8) ◽

pp. 990

Author(s):

Herman Morchel ◽

David Clark ◽

Leighanne Buenvenida ◽

Chinwe Ogedegbe

Keyword(s):

Emergency Department ◽

Monoclonal Antibody ◽

Patient Care ◽

Emergency Care ◽

Environmental Changes ◽

Physical Space ◽

Antibody Treatment ◽

Monoclonal Antibody Treatment ◽

Mobile Satellite ◽

Novel Coronavirus

The COVID-19 pandemic and the subsequent surge of patients presented to emergency departments has forever changed the paradigm of delivering emergency care. The highly infectious nature of the 2019 Novel Coronavirus, or COVID-19, mandated strict environmental changes, novel patient care, and flexible strategies to continue to deliver efficient emergency care while maintaining appropriate physical distancing between suspect and non-suspect COVID-19 patients. The engagement of a unique rapidly deployable Mobile Satellite Emergency Department (MSED) with scalable capability from prompt care to resuscitation level allowed the emergency care team to optimize patient care and throughput. The MSED was strategically located adjacent to the ambulance entrance. While initially deployed to increase Emergency Department surge capacity, the MSED was repurposed to cohort and treat COVID patients with the monoclonal antibody, Bamlanivimab, who were expected to be discharged after treatment. This allowed for more efficient use of Emergency Department resources, including physical space and staffing.

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Influence of Social and Cultural Factors on the Decision to Consent for Monoclonal Antibody Treatment among High-Risk Patients with Mild-Moderate COVID-19

Journal of Primary Care & Community Health ◽

10.1177/21501327211019282 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110192

Author(s):

Dennis M. Bierle ◽

Ravindra Ganesh ◽

Caroline G. Wilker ◽

Sara N. Hanson ◽

Darcie E. Moehnke ◽

...

Keyword(s):

Monoclonal Antibody ◽

High Risk ◽

Clinical Outcomes ◽

Antibody Therapy ◽

Cultural Factors ◽

Monoclonal Antibody Therapy ◽

Antibody Treatment ◽

Medical Comorbidities ◽

Monoclonal Antibody Treatment ◽

Social And Cultural Factors

Background The clinical outcomes of patients who decline anti-spike monoclonal antibody therapies for coronavirus disease-2019 (COVID-19) is not known. Factors associated with the decision to accept or decline the offer for anti-spike monoclonal antibody therapies are not established. This study aimed to identify factors impacting the decision to consent for monoclonal antibody therapies and assess the differences in clinical outcomes of patients who accepted compared to those who declined these therapies. Methods This retrospective cohort study enrolled 2820 adult patients who were offered monoclonal antibody therapies, bamlanivimab and casirivimab-imdevimab, for COVID-19 at Mayo Clinic in the Midwest between 11/19/2020 and 12/31/2020. The primary endpoint is the decision to accept or decline monoclonal antibody treatment. Secondary endpoints were patient-level factors that could have impacted the decision to accept treatment (age, gender, race, ethnicity, primary language spoken, and medical comorbidities). The main clinical endpoint was hospitalization within 28 days of COVID-19 diagnosis. Results 59.1% (n = 1669) chose to accept monoclonal antibody therapy, and 40.9% (n = 1151) chose to decline the offer for treatment. Patients were more likely to accept treatment if they were non-Hispanic White, English speaking, identified a spouse or life partner, had a religious affiliation, and possessed more medical comorbidities. Overall, 28-day hospitalization rate was 2.6% (n = 72/2820) and was higher among those who declined (3.3%) than those who accepted monoclonal antibody therapy (2.0%; Rate Ratio = 0.62, 95% Confidence Interval, 0.39-0.98). Conclusions Despite having more comorbidities, patients who accepted monoclonal antibody treatments had a lower rate of hospitalization compared to patients who declined treatment. Several social and cultural factors were associated with the decision to decline therapy, including race, language, ethnicity, and lack of social support. These findings can inform public health efforts to reduce social disparities in the treatment of COVID-19 and increase utilization of monoclonal antibody therapies in high risk populations.

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Impact of bamlanivimab monoclonal antibody treatment on hospitalization and mortality among non-hospitalized adults with SARS-CoV-2 infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab254 ◽

2021 ◽

Author(s):

J Ryan Bariola ◽

Erin K McCreary ◽

Richard J Wadas ◽

Kevin E Kip ◽

Oscar C Marroquin ◽

...

Keyword(s):

Emergency Department ◽

Monoclonal Antibody ◽

Emergency Department Visit ◽

Secondary Outcome ◽

Antibody Treatment ◽

Positive Polymerase Chain Reaction ◽

Propensity Matching ◽

Monoclonal Antibody Treatment ◽

Receive Treatment ◽

The Impact

Abstract Background Monoclonal antibody treatment may prevent complications of COVID-19. We sought to quantify the impact of bamlanivimab monoclonal antibody monotherapy on hospitalization and mortality among outpatients at high risk of COVID-19 complications. Methods In this observational study we compared outpatients who received bamlanivimab monoclonal antibody from December 9, 2020 to March 3, 2021 to non-treated patients with a positive polymerase chain reaction or antigen test for SARS-CoV-2 during the same period who were eligible for monoclonal antibody treatment. The primary outcome was 28-day hospitalization or all-cause mortality, and the secondary outcome was hospitalization or emergency department visit without hospitalization. The risk-adjusted odds of study outcomes comparing bamlanivimab treated and untreated patients was determined using 1:5 propensity matching and multivariable logistic regression. Results Among 232 patients receiving bamlanivimab matched with 1,160 comparator patients, the mean age was 67 years, 56% were female, and 196 (14%) of patients experienced hospitalization or mortality. After adjustment for propensity to receive treatment, bamlanivimab treatment was associated with a significantly reduced risk-adjusted odds of hospitalization or mortality within 28 days (OR 0.40, 95% confidence interval [95% CI] 0.24 to 0.69; p<.001). Bamlanivimab treatment was also associated with a significantly lower risk adjusted odds of hospitalization or emergency department visit without hospitalization (OR 0.54, 95% CI 0.35 to 0.82; p=.004). The results were most strongly associated with patients age 65 years and older. Conclusions Bamlanivimab monoclonal antibody monotherapy was associated with reduced hospitalizations and mortality within 28 days among outpatients with mild-moderate COVID-19.

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