ABSTRACT
Introduction: Health inequities in COVID-19 have led to disproportionate access to care and health outcomes. Research Question or Hypothesis: To describe the demographics of patients accessing COVID-19 monoclonal antibodies (mAb) at an urban, tertiary medical center. Study Design: A retrospective descriptive study. Method(s): Patients >=18 years of age with a positive SARS-CoV-2 viral test and received bamlanivimab or casirivimab/imdevimab at the University of California San Francisco (UCSF), between December 3, 2020, and October 3, 2021. Patients were stratified by race/ ethnicity and geographic area. Covariates included sex, age, days of symptoms, vaccination status/type, hospitalization, and length of hospital stay. For comparison, data describing race/ethnicity, COVID-19 cases, death, and the California Healthy Places Index (HPI) and Healthcare Access (HA) scores associated with zip codes were obtained from the City and County of San Francisco and the Public Health Alliance of Southern California. Statistical significance was determined at p < 0.05. This study was approved by the UCSF Institutional Review Board. Result(s): Of 559 patients who received mAb, 45.5% were White/ Caucasian, followed by Latinx (16.2%), Asian (14.4%), and Black/ African American (10.4%). Compared to White/Caucasian, Latinx patients were significantly younger, unvaccinated, and predominantly female. Asian patients were more likely to receive mAbs in the Emergency Department;Black/African American patients were more likely to be unvaccinated. More than half of the cohort who received mAb were from higher HPI and HA areas. There was a significant positive correlation between HPI score and White/ Caucasian population (R2=0.21, p< 0.05). Significantly less Latinx, Asian, and Black/African American who received mAb were observed in the higher HPI and HA score groups compared with White/Caucasian (p < 0.05). The rate of hospitalization was significantly higher in Asian patients (18.6%) compared to White/ Caucasian patients (6.7%) (p < 0.001). Conclusion(s): Imbalances in the racial/ethnic makeup, HPI and HA scores highlight potential inequities to mAb utilization and subsequent clinical outcomes.