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Infectious Disease Reports ; 14(3):315-320, 2022.
Article in English | MDPI | ID: covidwho-1809845


We present a brief commentary illustrating the current COVID-19 outpatient treatment options in Italy. We also report our experience setting up a service dedicated to these patients in the wake of the rise in COVID-19 cases observed in January 2022. We also gathered data on the daily costs faced by our outpatient service, based at a tertiary care center located in Florence, Italy. We present them with some considerations on future outlooks on the use of outpatient treatment in COVID-19.

Infection ; 2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1729429


PURPOSE: Pregnant and postpartum women are at increased risk of developing severe COVID-19. Monoclonal antibodies (mAbs) are now widely used in high-income countries to treat mild to moderate COVID-19 outpatients at risk for developing severe disease. Very few data are available on the use of mAbs in special populations, including pregnant and postpartum women. Here we present our early experience with mAbs in these two populations. METHODS: Electronic records of pregnant and postpartum women treated with mAbs at Careggi University Hospital, Florence, were retrieved. Relevant data were extracted (age, presence of risk factors for COVID-19, oxygen support, mAb type, gestational age, and pregnancy status). When available, outcomes at 28 days after administration were also included. RESULTS: From March 1st to September 30th 2021, eight pregnant and two postpartum women have been treated with mAbs at our center. The median age was 31 years (IQR 30-33.5, range 29-38), median gestational age was 24 weeks. Seven patients had additional risk factors. According to the Italian disposition, all patients received casirivimab/imdevimab, with five receiving a 2.4 mg dose and five receiving a 8 g dose. Eight patients improved. One developed myocarditis, considered a COVID-19 complication. Another required a transient increase of low flow oxygen support before improving and being discharged. At a 28 days follow-up, all patients were clinically recovered. We did not observe mAbs related adverse events. CONCLUSION: Although preliminary data should be interpreted with caution, it is remarkable how mAbs were well tolerated by pregnant women with COVID-19. Further data on mAbs in this special population should be collected but the use of mAbs in pregnant and postpartum patients should be considered. Even thus oral antivirals are becoming available, they are not recommended in pregnant and postpartum women. This population may specifically benefit from treatment with last generation mAbs.

Infect Dis Ther ; 11(1): 629-633, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1565479


Recently, the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP) published guidelines on the management of inpatients with COVID-19. The guidelines do not recommend the use of monoclonal antibodies (mAbs) in inpatients, pending results from clinical trials. However, recently the Italian Drug Agency (AIFA) has allowed for the use of casirivimab/imdevimab at higher doses in hospitalized seronegative patients with COVID-19. Furthermore, several other therapeutic options based on mAbs are about to become available for outpatients. Here we provide a brief summary of the future possibilities and summarize existing data.