ABSTRACT
Background:Dexamethasone reduces the mortality in patients with severe COVID-19. We evaluated the decline in C-reactive protein (CRP) after the treatment with standard dose dexamethasone and its association with mortality and body mass index (BMI).Material and Methods&Results:This was a retrospective cohort of 678 patients with COVID-19 admitted to the public healthcare system of New York City between July 1st and December 31st, 2020 with laboratory-confirmed COVID-19, who received at least one dose of dexamethasone and had more than one measurement of CRP. Mortality was compared among groups stratified by BMI and CRP response. The reference group had BMI 25-34.9 kg/m2 and CRP response. Male sex, increasing age and CRP non-response were associated with higher in-hospital mortality. Patients with BMI 25-34.9 kg/m2 and CRP non-response (OR 2.71 [1.43-5.15];p=0.002) and BMI > 35 kg/m2 and CRP non-response (OR 2.64 [1.05-6.62];p=0.038) were associated with higher mortality.Conclusion:CRP non-response was associated with a higher likelihood for death after adjusting for other confounding factors. The CRP non-response rate was significantly higher in patients with severe obesity.
ABSTRACT
Background Coronavirus disease 2019 (Covid-19) presents as a mild infection in up to 84% of cases out of which 10% progress to more severe disease requiring hospitalization and 33% to 69% progress to long haulers. The real-world data on the use of anti-severe acute respiratory syndrome coronavirus 2 spike neutralizing monoclonal antibodies, namely casirivimab and imdevimab, as well as bamlanivimab for mild Covid-19 is limited. Methods We conducted a retrospective cohort study on patients who received casirivimab and imdevimab or bamlanivimab for the treatment of mild Covid-19. Results Three hundred forty patients were included in the study with the mean age of the cohort 54.7 +/- 17.5 years, and 36.5% of them were men. Thirty-day outcomes revealed that 300 (88.2%) patients were followed up to 30 days, out of which 243 patients (71.5%) were asymptomatic at 30 days, 57 patients (16.7%) had symptoms at 30 days out of which 9 patients (2.6%) had an ED visit or were admitted because of the worsening of Covid-19 in 30 days and 3 patients (0.9%) died. Conclusions Our study suggests that early infusion with monoclonal antibodies may decrease the development of long haulers. Further studies with randomized-controlled trials are needed to understand more about monoclonal antibodies in the prevention of long-term sequelae especially in the setting of ongoing viral mutations.