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Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients.
Douin, David J; Wogu, Adane F; Beaty, Laurel E; Carlson, Nichole E; Bennett, Tellen D; Aggarwal, Neil R; Mayer, David A; Ong, Toan C; Russell, Seth; Steele, Jeffrey; Peers, Jennifer L; Molina, Kyle C; Wynia, Matthew K; Ginde, Adit A.
  • Douin DJ; Department of Anesthesiology, University of Colorado School of Medicine, 12401 E. 17th Avenue, B-215, Aurora, CO, 80045, USA. david.douin@cuanschutz.edu.
  • Wogu AF; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
  • Beaty LE; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
  • Carlson NE; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
  • Bennett TD; Colorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Aggarwal NR; Colorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Mayer DA; Section of Informatics and Data Science, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
  • Ong TC; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Russell S; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
  • Steele J; Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Peers JL; Section of Informatics and Data Science, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
  • Molina KC; Research Informatics, Children's Hospital Colorado, Aurora, CO, USA.
  • Wynia MK; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
  • Ginde AA; Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA.
BMC Infect Dis ; 22(1): 818, 2022 Nov 07.
Статья в английский | MEDLINE | ID: covidwho-2108748
ABSTRACT

BACKGROUND:

Neutralizing monoclonal antibodies (mAbs) are highly effective in reducing hospitalization and mortality among early symptomatic COVID-19 patients in clinical trials and real-world data. While resistance to some mAbs has since emerged among new variants, characteristics associated with treatment failure of mAbs remain unknown.

METHODS:

This multicenter, observational cohort study included patients with COVID-19 who received mAb treatment between November 20, 2020, and December 9, 2021. We utilized electronic health records from a statewide health system plus state-level vaccine and mortality data. The primary outcome was mAb treatment failure, defined as hospitalization or death within 28 days of a positive SARS-CoV-2 test.

RESULTS:

COVID-19 mAb was administered to 7406 patients. Hospitalization within 28 days of positive SARS-CoV-2 test occurred in 258 (3.5%) of all patients who received mAb treatment. Ten patients (0.1%) died within 28 days, and all but one were hospitalized prior to death. Characteristics associated with treatment failure included having two or more comorbidities excluding obesity and immunocompromised status (adjusted odds ratio [OR] 3.71, 95% confidence interval [CI] 2.52-5.56), lack of SARS-CoV-2 vaccination (OR 2.73, 95% CI 2.01-3.77), non-Hispanic black race/ethnicity (OR 2.21, 95% CI 1.20-3.82), obesity (OR 1.79, 95% CI 1.36-2.34), one comorbidity (OR 1.68, 95% CI 1.11-2.57), age ≥ 65 years (OR 1.62, 95% CI 1.13-2.35), and male sex (OR 1.56, 95% CI 1.21-2.02). Immunocompromised status (none, mild, or moderate/severe), pandemic phase, and type of mAb received were not associated with treatment failure (all p > 0.05).

CONCLUSIONS:

Comorbidities, lack of prior SARS-CoV-2 vaccination, non-Hispanic black race/ethnicity, obesity, age ≥ 65 years, and male sex are associated with treatment failure of mAbs.
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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: COVID-19 Тип исследования: Когортное исследование / Наблюдательное исследование / Прогностическое исследование Темы: Вакцина / Варианты Пределы темы: Пожилые / Люди / Мужчины Язык: английский Журнал: BMC Infect Dis Тематика журнала: Инфекционные болезни Год: 2022 Тип: Статья Аффилированная страна: S12879-022-07819-z

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: COVID-19 Тип исследования: Когортное исследование / Наблюдательное исследование / Прогностическое исследование Темы: Вакцина / Варианты Пределы темы: Пожилые / Люди / Мужчины Язык: английский Журнал: BMC Infect Dis Тематика журнала: Инфекционные болезни Год: 2022 Тип: Статья Аффилированная страна: S12879-022-07819-z