Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

COVID-19 SARS-CoV-2 bamlanivimab monoclonal antibodies

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 30 04 2021
accepted: 12 05 2021
entrez: 12 7 2021
pubmed: 13 7 2021
medline: 13 7 2021
Statut: epublish

Résumé

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. 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 1:5 propensity matching and multivariable logistic regression. 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; 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.

Sections du résumé

BACKGROUND 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 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 1:5 propensity matching and multivariable logistic regression.
RESULTS 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;
CONCLUSIONS 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.

Identifiants

pubmed: 34250192
doi: 10.1093/ofid/ofab254
pii: ofab254
pmc: PMC8241472
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofab254

Subventions

Organisme : NIAID NIH HHS
ID : K23 AI154546
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM119519
Pays : United States

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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Auteurs

J Ryan Bariola (JR)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Erin K McCreary (EK)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Richard J Wadas (RJ)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Kevin E Kip (KE)

Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Oscar C Marroquin (OC)

Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Tami Minnier (T)

Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Stephen Koscumb (S)

Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Kevin Collins (K)

Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Mark Schmidhofer (M)

Division of Cardiology, Dept of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Judith A Shovel (JA)

Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Mary Kay Wisniewski (MK)

Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Colleen Sullivan (C)

UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.

Donald M Yealy (DM)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

David A Nace (DA)

Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

David T Huang (DT)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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.

Ghady Haidar (G)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Tina Khadem (T)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Kelsey Linstrum (K)

UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
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.

Christopher W Seymour (CW)

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
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.

Stephanie K Montgomery (SK)

UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
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.

Derek C Angus (DC)

UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania, USA.
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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.

Graham M Snyder (GM)

Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Classifications MeSH