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Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.
Bariola, J Ryan; McCreary, Erin K; Wadas, Richard J; Kip, Kevin E; Marroquin, Oscar C; Minnier, Tami; Koscumb, Stephen; Collins, Kevin; Schmidhofer, Mark; Shovel, Judith A; Wisniewski, Mary Kay; Sullivan, Colleen; Yealy, Donald M; Nace, David A; Huang, David T; Haidar, Ghady; Khadem, Tina; Linstrum, Kelsey; Seymour, Christopher W; Montgomery, Stephanie K; Angus, Derek C; Snyder, Graham M.
  • Bariola JR; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • McCreary EK; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Wadas RJ; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Kip KE; Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Marroquin OC; Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Minnier T; Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Koscumb S; Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Collins K; Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Schmidhofer M; Division of Cardiology, Dept of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Shovel JA; Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Wisniewski MK; Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Sullivan C; UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
  • Yealy DM; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Nace DA; Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Huang DT; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Haidar G; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Khadem T; Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Linstrum K; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Seymour CW; Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Montgomery SK; UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
  • Angus DC; Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Snyder GM; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Open Forum Infect Dis ; 8(7): ofab254, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1305436
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 15 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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid