tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 May 17;8(7)
fab254.
doi: 10.1093/ofid/ofab254. eCollection 2021 Jul.
Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection
J Ryan Bariola[SUP] 1 [/SUP], Erin K McCreary[SUP] 1 [/SUP], Richard J Wadas[SUP] 2 [/SUP], Kevin E Kip[SUP] 3 [/SUP], Oscar C Marroquin[SUP] 3 [/SUP], Tami Minnier[SUP] 4 [/SUP], Stephen Koscumb[SUP] 3 [/SUP], Kevin Collins[SUP] 3 [/SUP], Mark Schmidhofer[SUP] 5 [/SUP], Judith A Shovel[SUP] 4 [/SUP], Mary Kay Wisniewski[SUP] 4 [/SUP], Colleen Sullivan[SUP] 6 [/SUP], Donald M Yealy[SUP] 2 [/SUP], David A Nace[SUP] 7 [/SUP], David T Huang[SUP] 2 8 9 [/SUP], Ghady Haidar[SUP] 1 [/SUP], Tina Khadem[SUP] 1 [/SUP], Kelsey Linstrum[SUP] 6 9 [/SUP], Christopher W Seymour[SUP] 2 6 9 [/SUP], Stephanie K Montgomery[SUP] 6 9 [/SUP], Derek C Angus[SUP] 6 8 9 [/SUP], Graham M Snyder[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Monoclonal antibody treatment may prevent complications of coronavirus disease 2019 (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 nontreated patients with a positive polymerase chain reaction or antigen test for severe acute respiratory syndrome coronavirus 2 (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 1160 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 (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.24-0.69; 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, 0.35-0.82; 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 to moderate COVID-19.Use of bamlanivimab monotherapy for outpatients with mild to moderate COVID-19 infection was associated with reductions in hospitalizations and mortality within 28 days. Benefit was strongest in those age 65 years or older.
Keywords: COVID-19; SARS-CoV-2; bamlanivimab; monoclonal antibodies.
. 2021 May 17;8(7)
fab254.doi: 10.1093/ofid/ofab254. eCollection 2021 Jul.
Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection
J Ryan Bariola[SUP] 1 [/SUP], Erin K McCreary[SUP] 1 [/SUP], Richard J Wadas[SUP] 2 [/SUP], Kevin E Kip[SUP] 3 [/SUP], Oscar C Marroquin[SUP] 3 [/SUP], Tami Minnier[SUP] 4 [/SUP], Stephen Koscumb[SUP] 3 [/SUP], Kevin Collins[SUP] 3 [/SUP], Mark Schmidhofer[SUP] 5 [/SUP], Judith A Shovel[SUP] 4 [/SUP], Mary Kay Wisniewski[SUP] 4 [/SUP], Colleen Sullivan[SUP] 6 [/SUP], Donald M Yealy[SUP] 2 [/SUP], David A Nace[SUP] 7 [/SUP], David T Huang[SUP] 2 8 9 [/SUP], Ghady Haidar[SUP] 1 [/SUP], Tina Khadem[SUP] 1 [/SUP], Kelsey Linstrum[SUP] 6 9 [/SUP], Christopher W Seymour[SUP] 2 6 9 [/SUP], Stephanie K Montgomery[SUP] 6 9 [/SUP], Derek C Angus[SUP] 6 8 9 [/SUP], Graham M Snyder[SUP] 1 [/SUP]
Affiliations
- PMID: 34250192
- PMCID: PMC8241472
- DOI: 10.1093/ofid/ofab254
Abstract
Background: Monoclonal antibody treatment may prevent complications of coronavirus disease 2019 (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 nontreated patients with a positive polymerase chain reaction or antigen test for severe acute respiratory syndrome coronavirus 2 (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 1160 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 (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.24-0.69; 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, 0.35-0.82; 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 to moderate COVID-19.Use of bamlanivimab monotherapy for outpatients with mild to moderate COVID-19 infection was associated with reductions in hospitalizations and mortality within 28 days. Benefit was strongest in those age 65 years or older.
Keywords: COVID-19; SARS-CoV-2; bamlanivimab; monoclonal antibodies.