tetano
Editor, Senior Moderator
Mayo Clin Proc Innov Qual Outcomes
. 2023 Jan 11.
doi: 10.1016/j.mayocpiqo.2022.12.007. Online ahead of print.
Association of Neutralizing Anti-spike Monoclonal Antibody Treatment With COVID-19 Hospitalization and Assessment of the Monoclonal Antibody Screening Score
Patrick W Johnson[SUP] 1 [/SUP], Katie L Kunze[SUP] 2 [/SUP], Jonathon W Senefeld[SUP] 3 [/SUP], Jorge E Sinclair[SUP] 4 [/SUP], Shahin Isha[SUP] 4 [/SUP], Parthkumar H Satashia[SUP] 4 [/SUP], Shivang Bhakta[SUP] 4 [/SUP], Jennifer B Cowart[SUP] 5 [/SUP], Wendelyn Bosch[SUP] 6 [/SUP], Jack O'Horo[SUP] 7 8 [/SUP], Sadia Z Shah[SUP] 9 [/SUP], Hani M Wadei[SUP] 9 [/SUP], Michael A Edwards[SUP] 10 [/SUP], Benjamin D Pollock[SUP] 11 [/SUP], Alana J Edwards[SUP] 1 [/SUP], Sidna Scheitel-Tulledge[SUP] 12 [/SUP], Caroline G Clune[SUP] 13 [/SUP], Sara N Hanson[SUP] 14 [/SUP], Richard Arndt[SUP] 15 [/SUP], Alexander Heyliger[SUP] 16 [/SUP], Cory Kudrna[SUP] 17 [/SUP], Dennis M Bierle[SUP] 18 [/SUP], Jason R Buckmeier[SUP] 17 [/SUP], Maria Teresa A Seville[SUP] 19 [/SUP], Robert Orenstein[SUP] 20 [/SUP], Claudia Libertin[SUP] 6 [/SUP], Ravindra Ganesh[SUP] 18 [/SUP], Pablo Moreno Franco[SUP] 4 9 11 [/SUP], Raymund R Razonable[SUP] 7 [/SUP], Rickey E Carter[SUP] 1 [/SUP], Devang K Sanghavi[SUP] 4 [/SUP], Leigh L Speicher[SUP] 21 [/SUP]
Affiliations
Abstract
Objective: To test the hypothesis that the MASS Score performs consistently better in identifying need for monoclonal-antibody infusion throughout each "wave" of SARS-CoV-2 variant predominance during the COVID-19 pandemic and the infusion of contemporary monoclonal-antibody treatments is associated with a lower risk of hospitalization.
Patients and methods: In this retrospective cohort study, we evaluated the efficacy of monoclonal-antibody treatment as compared to no monoclonal-antibody treatment in symptomatic adults who tested positive for SARS-CoV-2, regardless of their risk factors for disease progression or vaccination status during different periods of SARS-CoV-2 variant predominance. The primary outcome was hospitalization within 28 days after COVID-19 diagnosis. The study was conducted on patients diagnosed with COVID-19 from November 19, 2020, through May 12, 2022.
Results: Of the included 118,936 eligible patients, hospitalization within 28 days of COVID-19 diagnosis occurred in 2.52% (456/18,090) of patients who received monoclonal-antibody treatment and 6.98% (7,037/100,846) of patients who did not. Treatment with monoclonal-antibody therapies was associated with a lower risk of hospitalization when using stratified data analytics, propensity scoring, and regression and machine learning models with and without adjustments for putative confounding variables, such as advanced age and coexisting medical conditions (e.g., relative risk: 0.15; 95% CI, 0.14 to 0.17).
Conclusions: Among patients with mild to moderate COVID-19, including those who have been vaccinated, monoclonal-antibody treatment was associated with a lower risk of hospital admission during each wave of the COVID-19 pandemic.
Keywords: CMH, Cochran Mantel Haenszel; COVID-19, Coronavirus Disease 2019; GBM, Gradient Boosting Machine; MASS, Monoclonal Antibody Screening Score; SARS-CoV-2, Severe Acute Respiratory Syndrome Corona Virus 2.
. 2023 Jan 11.
doi: 10.1016/j.mayocpiqo.2022.12.007. Online ahead of print.
Association of Neutralizing Anti-spike Monoclonal Antibody Treatment With COVID-19 Hospitalization and Assessment of the Monoclonal Antibody Screening Score
Patrick W Johnson[SUP] 1 [/SUP], Katie L Kunze[SUP] 2 [/SUP], Jonathon W Senefeld[SUP] 3 [/SUP], Jorge E Sinclair[SUP] 4 [/SUP], Shahin Isha[SUP] 4 [/SUP], Parthkumar H Satashia[SUP] 4 [/SUP], Shivang Bhakta[SUP] 4 [/SUP], Jennifer B Cowart[SUP] 5 [/SUP], Wendelyn Bosch[SUP] 6 [/SUP], Jack O'Horo[SUP] 7 8 [/SUP], Sadia Z Shah[SUP] 9 [/SUP], Hani M Wadei[SUP] 9 [/SUP], Michael A Edwards[SUP] 10 [/SUP], Benjamin D Pollock[SUP] 11 [/SUP], Alana J Edwards[SUP] 1 [/SUP], Sidna Scheitel-Tulledge[SUP] 12 [/SUP], Caroline G Clune[SUP] 13 [/SUP], Sara N Hanson[SUP] 14 [/SUP], Richard Arndt[SUP] 15 [/SUP], Alexander Heyliger[SUP] 16 [/SUP], Cory Kudrna[SUP] 17 [/SUP], Dennis M Bierle[SUP] 18 [/SUP], Jason R Buckmeier[SUP] 17 [/SUP], Maria Teresa A Seville[SUP] 19 [/SUP], Robert Orenstein[SUP] 20 [/SUP], Claudia Libertin[SUP] 6 [/SUP], Ravindra Ganesh[SUP] 18 [/SUP], Pablo Moreno Franco[SUP] 4 9 11 [/SUP], Raymund R Razonable[SUP] 7 [/SUP], Rickey E Carter[SUP] 1 [/SUP], Devang K Sanghavi[SUP] 4 [/SUP], Leigh L Speicher[SUP] 21 [/SUP]
Affiliations
- PMID: 36644593
- PMCID: PMC9832055
- DOI: 10.1016/j.mayocpiqo.2022.12.007
Abstract
Objective: To test the hypothesis that the MASS Score performs consistently better in identifying need for monoclonal-antibody infusion throughout each "wave" of SARS-CoV-2 variant predominance during the COVID-19 pandemic and the infusion of contemporary monoclonal-antibody treatments is associated with a lower risk of hospitalization.
Patients and methods: In this retrospective cohort study, we evaluated the efficacy of monoclonal-antibody treatment as compared to no monoclonal-antibody treatment in symptomatic adults who tested positive for SARS-CoV-2, regardless of their risk factors for disease progression or vaccination status during different periods of SARS-CoV-2 variant predominance. The primary outcome was hospitalization within 28 days after COVID-19 diagnosis. The study was conducted on patients diagnosed with COVID-19 from November 19, 2020, through May 12, 2022.
Results: Of the included 118,936 eligible patients, hospitalization within 28 days of COVID-19 diagnosis occurred in 2.52% (456/18,090) of patients who received monoclonal-antibody treatment and 6.98% (7,037/100,846) of patients who did not. Treatment with monoclonal-antibody therapies was associated with a lower risk of hospitalization when using stratified data analytics, propensity scoring, and regression and machine learning models with and without adjustments for putative confounding variables, such as advanced age and coexisting medical conditions (e.g., relative risk: 0.15; 95% CI, 0.14 to 0.17).
Conclusions: Among patients with mild to moderate COVID-19, including those who have been vaccinated, monoclonal-antibody treatment was associated with a lower risk of hospital admission during each wave of the COVID-19 pandemic.
Keywords: CMH, Cochran Mantel Haenszel; COVID-19, Coronavirus Disease 2019; GBM, Gradient Boosting Machine; MASS, Monoclonal Antibody Screening Score; SARS-CoV-2, Severe Acute Respiratory Syndrome Corona Virus 2.