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Neutralizing Monoclonal Antibodies for Coronavirus Disease 2019 (COVID-19) in Pregnancy: A Case Series.
Richley, Michael; Rao, Rashmi R; Afshar, Yalda; Mei, Jenny; Mok, Thalia; Vijayan, Tara; Weinstein, Stacey; Pham, Christine U; Madamba, Jason; Shin, Christina S; Suda, Deborah; Han, Christina S.
  • Richley M; Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, and the Division of Infectious Diseases, Department of Internal Medicine, David Geffen School of Medicine at UCLA, and the Department of Pharmaceutical Services, Ronald Reagan UCLA Medical Center, Los Angeles, California.
Obstet Gynecol ; 139(3): 368-372, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-2222779
ABSTRACT

OBJECTIVE:

To describe outcomes associated with monoclonal antibody use in pregnant persons with mild-to-moderate coronavirus disease 2019 (COVID-19).

METHODS:

We present a retrospective case series of pregnant patients who received anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibody infusions at a single center from April 1, 2021, through October 16, 2021. Pregnant patients who had a positive SARS-CoV-2 polymerase chain reaction (PCR) test result and mild-to-moderate COVID-19 symptoms were eligible for monoclonal antibody infusion. Exclusion criteria for administration included need for supplemental oxygen, hospitalization due to COVID-19, and positive SARS-CoV-2 PCR test result more than 7 days before screening. All patients received either bamlanivimab plus etesevimab or casirivimab plus imdevimab based on availability and dosing instructions of the product and emerging resistance patterns in the community.

RESULTS:

During the study period, monoclonal antibody infusions were administered to 450 individuals at our institution, of whom 15 were pregnant. Of the 15 pregnant persons receiving monoclonal antibody, six (40%) had full-vaccination status at the time of infusion. Two individuals (13%, CI 0-31%) experienced systemic reactions during the infusion, both resulting in temporary changes in the fetal heart rate tracing that recovered with maternal and intrauterine resuscitative efforts. One patient delivered after infusion for worsening maternal and fetal status; the remainder of the patients did not require admission for COVID-19.

CONCLUSION:

In this case series, pregnant persons who received anti-SARS-CoV-2 monoclonal antibody infusions had generally favorable outcomes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Antibodies, Neutralizing / Antibodies, Monoclonal, Humanized / COVID-19 Drug Treatment / Antibodies, Monoclonal Type of study: Case report / Observational study Topics: Vaccines Limits: Female / Humans / Pregnancy Language: English Journal: Obstet Gynecol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Antibodies, Neutralizing / Antibodies, Monoclonal, Humanized / COVID-19 Drug Treatment / Antibodies, Monoclonal Type of study: Case report / Observational study Topics: Vaccines Limits: Female / Humans / Pregnancy Language: English Journal: Obstet Gynecol Year: 2022 Document Type: Article