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J Pediatr Pharmacol Ther . Effectiveness and Safety of Outpatient Monoclonal Antibody Use for the Treatment of COVID-19 in Children and Adolescents:

tetano

Editor, Senior Moderator
J Pediatr Pharmacol Ther


. 2025 Oct;30(5):655-659.
doi: 10.5863/JPPT-24-00095. Epub 2025 Oct 17. Effectiveness and Safety of Outpatient Monoclonal Antibody Use for the Treatment of COVID-19 in Children and Adolescents: Single Center Study

Julia Cheng[SUP] 1 [/SUP], Emily Heideman[SUP] 1 [/SUP], Claudia Espinosa[SUP] 2 [/SUP], Kristen Zeitler[SUP] 3 [/SUP], Nicholas Piccicacco[SUP] 3 [/SUP], Claudia Gaviria-Agudelo[SUP] 2 [/SUP]



Affiliations
Abstract

Objective: Monoclonal antibody therapy has been used to treat COVID-19, with paucity of literature about its use in children. This retrospective study sought to evaluate the effectiveness of preventing hospitalization and safety of monoclonal antibody (mAb) treatment (bamlanivimab-etesevimab and casirivimab-imdevimab) for COVID-19 in patients ≤18 years of age.
Methods: Between January 1 and December 31, 2021, patients were selected for mAb therapy, based on the referring provider's clinical assessment of high risk for progression to severe COVID-19. The choice of mAb was determined by drug availability, compounding feasibility, and documented in vitro activity against circulating SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) variants. All patients received a single-dose infusion. Primary outcomes included hospital readmissions and emergency department (ED) visits within 90 days of treatment. The secondary outcome was safety/adverse events.
Results: Of 141 patients who received mAbs in 2021, only 3 experienced ongoing COVID-19 symptoms. Only 1 patient necessitated escalated care owing to persistent COVID-19 symptoms post infusion. There were no infusion-related side effects or hospitalizations in the 90 days post infusion.
Conclusion: Monoclonal antibodies appear to be safe and effective in preventing hospitalizations in COVID-19-positive children.

Keywords: COVID-19; immunotherapy; monoclonal antibodies; pediatrics.

 
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