tetano
Editor, Senior Moderator
J Am Geriatr Soc
. 2021 Feb 22.
doi: 10.1111/jgs.17090. Online ahead of print.
A Mobile Unit Overcomes the Challenges to Monoclonal Antibody Infusion for COVID-19 in Skilled Care Facilities
Sidna Tulledge-Scheitel[SUP] 1 [/SUP], Sara J Bell[SUP] 2 [/SUP], Jennifer J Larsen[SUP] 2 [/SUP], Dennis M Bierle[SUP] 3 [/SUP], Paul Takahashi[SUP] 1 [/SUP], Darcie E Moehnke[SUP] 2 [/SUP], Molly J Destro Borgen[SUP] 4 [/SUP], Donna J Springer[SUP] 5 [/SUP], Karen J Reinschmidt[SUP] 6 [/SUP], Lori J Baumbach[SUP] 1 [/SUP], Jennifer A Matoush[SUP] 2 [/SUP], Alexander Heyliger[SUP] 7 [/SUP], Sara N Hanson[SUP] 8 [/SUP], Raymund R Razonable[SUP] 5 [/SUP], Ravindra Ganesh[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Residents of nursing homes and long-term care facilities are at increased risk for severe coronavirus disease-19 (COVID-19) but may not be able to access monoclonal antibody therapies offered at outpatient infusion centers due to frailty and logistical issues. We describe a mobile monoclonal antibody infusion program for patients with COVID-19 in skilled nursing facilities and provide descriptive data on its outcomes.
Design: Retrospective cohort study SETTING: Collaboration between Mayo Clinic and skilled nursing facilities in Southeast Minnesota was developed to administer anti-spike monoclonal antibodies under the FDA Emergency Use Authorization.
Participants: 75 residents of skilled nursing facilities at high risk of COVID-19 complications EXPOSURE: Emergency use treatment with bamlanivimab and casirivimab-imdevimab MEASUREMENTS: Hospitalization and medically attended visits RESULTS: The mobile infusion unit, staffed by Mayo Clinic Infusion Therapy registered nurses and supported by the skilled nursing facility staff, infused anti-spike monoclonal antibodies to 45 of 75 patients (average age, 77.8 years) in December 2020. The infusions occurred at an average of 4.3 days after COVID-19 diagnosis. Fourteen days after infusion, there were no deaths, two emergency department visits, and 3 hospitalizations, for a combined event rate of 11.1%. There was one reported adverse event.
Conclusion: The implementation of a mobile infusion unit embedded in a collaborative process resulted in rapid infusion of monoclonal antibodies to high-risk COVID-19 patients in skilled nursing facilities, who would otherwise be unable to access the novel therapies. The therapies were well tolerated and appear beneficial. Further study is warranted to explore the scalability and efficacy of this program.
Keywords: SARS-CoV-2; bamlanivimab; casirivimab; covid-19; monoclonal antibodies.
. 2021 Feb 22.
doi: 10.1111/jgs.17090. Online ahead of print.
A Mobile Unit Overcomes the Challenges to Monoclonal Antibody Infusion for COVID-19 in Skilled Care Facilities
Sidna Tulledge-Scheitel[SUP] 1 [/SUP], Sara J Bell[SUP] 2 [/SUP], Jennifer J Larsen[SUP] 2 [/SUP], Dennis M Bierle[SUP] 3 [/SUP], Paul Takahashi[SUP] 1 [/SUP], Darcie E Moehnke[SUP] 2 [/SUP], Molly J Destro Borgen[SUP] 4 [/SUP], Donna J Springer[SUP] 5 [/SUP], Karen J Reinschmidt[SUP] 6 [/SUP], Lori J Baumbach[SUP] 1 [/SUP], Jennifer A Matoush[SUP] 2 [/SUP], Alexander Heyliger[SUP] 7 [/SUP], Sara N Hanson[SUP] 8 [/SUP], Raymund R Razonable[SUP] 5 [/SUP], Ravindra Ganesh[SUP] 3 [/SUP]
Affiliations
- PMID: 33619724
- DOI: 10.1111/jgs.17090
Abstract
Background: Residents of nursing homes and long-term care facilities are at increased risk for severe coronavirus disease-19 (COVID-19) but may not be able to access monoclonal antibody therapies offered at outpatient infusion centers due to frailty and logistical issues. We describe a mobile monoclonal antibody infusion program for patients with COVID-19 in skilled nursing facilities and provide descriptive data on its outcomes.
Design: Retrospective cohort study SETTING: Collaboration between Mayo Clinic and skilled nursing facilities in Southeast Minnesota was developed to administer anti-spike monoclonal antibodies under the FDA Emergency Use Authorization.
Participants: 75 residents of skilled nursing facilities at high risk of COVID-19 complications EXPOSURE: Emergency use treatment with bamlanivimab and casirivimab-imdevimab MEASUREMENTS: Hospitalization and medically attended visits RESULTS: The mobile infusion unit, staffed by Mayo Clinic Infusion Therapy registered nurses and supported by the skilled nursing facility staff, infused anti-spike monoclonal antibodies to 45 of 75 patients (average age, 77.8 years) in December 2020. The infusions occurred at an average of 4.3 days after COVID-19 diagnosis. Fourteen days after infusion, there were no deaths, two emergency department visits, and 3 hospitalizations, for a combined event rate of 11.1%. There was one reported adverse event.
Conclusion: The implementation of a mobile infusion unit embedded in a collaborative process resulted in rapid infusion of monoclonal antibodies to high-risk COVID-19 patients in skilled nursing facilities, who would otherwise be unable to access the novel therapies. The therapies were well tolerated and appear beneficial. Further study is warranted to explore the scalability and efficacy of this program.
Keywords: SARS-CoV-2; bamlanivimab; casirivimab; covid-19; monoclonal antibodies.