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Effectiveness of Monoclonal Antibodies in Preventing Severe COVID-19 With Emergence of the Delta Variant.
O'Horo, John C; Challener, Douglas W; Speicher, Leigh; Bosch, Wendelyn; Seville, Maria Teresa; Bierle, Dennis M; Ganesh, Ravindra; Wilker, Caroline G; Arndt, Richard F; Arndt, Lori L; Tulledge-Scheitel, Sidna M; Hanson, Sara N; Razonable, Raymund R.
  • O'Horo JC; Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
  • Challener DW; Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
  • Speicher L; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL.
  • Bosch W; Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL.
  • Seville MT; Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ.
  • Bierle DM; Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
  • Ganesh R; Division of General Internal Medicine, Mayo Clinic, Rochester, MN.
  • Wilker CG; Division of Primary Care Internal Medicine, Mayo Clinic Health System, La Crosse, WI.
  • Arndt RF; Department of Pharmacy, Mayo Clinic Health System, Eau Claire, WI.
  • Arndt LL; Division of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI.
  • Tulledge-Scheitel SM; Division of Community Internal Medicine, Mayo Clinic, Rochester, MN.
  • Hanson SN; Division of Family Medicine, Mayo Clinic Health System, Mankato, MN.
  • Razonable RR; Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: Razonable.raymund@mayo.edu.
Mayo Clin Proc ; 97(2): 327-332, 2022 02.
Article in English | MEDLINE | ID: covidwho-1665267
ABSTRACT
Anti-spike monoclonal antibodies have proven invaluable in preventing severe outcomes from COVID-19, including hospitalization and death. The rise of the SARS-CoV-2 delta variant begs the question of whether monoclonal antibodies maintain similar efficacy now as they had when the alpha and beta variants predominated, when they were first assessed and approved. We used a retrospective cohort to compare rates of severe outcomes in an epoch in which alpha and beta were predominant compared with delta. A total of 5356 patients were infused during the alpha/beta variant-predominant (n=4874) and delta variant-predominant (n=482) era. Overall, odds of severe infection were 3.0% of patients in the alpha/beta-predominant era compared with 4.9% in the delta-predominant cohort. The unadjusted odds ratio (OR) was higher for severe disease in the delta era (OR, 1.67; 95% CI, 0.96 to 2.89), particularly when adjusted for Charlson Comorbidity Index (adjusted OR, 2.04; 95% CI, 1.30 to 3.08). The higher odds of severe infection could be due to a more virulent delta variant, although the possibility of decreased anti-spike monoclonal antibody effectiveness in the clinical setting cannot be excluded. Research into the most effective strategies for using and improving anti-spike monoclonals for the treatment of emerging variants is warranted.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 / Immunologic Factors / Antibodies, Monoclonal Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Mayo Clin Proc Year: 2022 Document Type: Article Affiliation country: J.mayocp.2021.12.002

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 / Immunologic Factors / Antibodies, Monoclonal Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Mayo Clin Proc Year: 2022 Document Type: Article Affiliation country: J.mayocp.2021.12.002