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A Propensity-Matched Cohort Assessing Impact of a Neutralizing Monoclonal Antibody in Mild-to-Moderate Coronavirus Disease 2019.
Abbas, Malak; Farhat, Nada; Hammoud, Zainab; Dickey, Curtis; Shuayto, Ali; Chen, Nai-Wei; Hsaiky, Lama M; Sims, Matthew; Sengstock, David; Schramski, Joseph; Shamoon, Zafar.
Afiliação
  • Abbas M; Pharmacy Department, Beaumont Health, Dearborn, MI, USA.
  • Farhat N; Pharmacy Department, Henry Ford Health, Detroit, MI, USA.
  • Hammoud Z; Emergency Center, Beaumont Health, Dearborn, MI, USA.
  • Dickey C; Emergency Center, Beaumont Health, Dearborn, MI, USA.
  • Shuayto A; Emergency Center, Beaumont Health, Dearborn, MI, USA.
  • Chen NW; Division of Informatics and Biostatistics, Beaumont Health, Royal Oak, MI, USA.
  • Hsaiky LM; Pharmacy Department, Beaumont Health, Dearborn, MI, USA.
  • Sims M; Section of Infectious Diseases and International Medicine, Department of Internal Medicine, Beaumont Health, Royal Oak, MI, USA.
  • Sengstock D; Department of Geriatric Medicine, Beaumont Health, Dearborn, MI, USA.
  • Schramski J; Emergency Center, Beaumont Health, Dearborn, MI, USA.
  • Shamoon Z; Emergency Center, Beaumont Health, Dearborn, MI, USA.
J Intensive Care Med ; 38(6): 511-518, 2023 Jun.
Article em En | MEDLINE | ID: mdl-36775970
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoaV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic. In randomized clinical trials, patients who were treated with the anti-spike monoclonal antibody bamlanivimab had fewer COVID-19-related hospitalizations or emergency department (ED) visits than the control group. Methods: A retrospective cohort was assembled across a multisite healthcare system between November 20, 2020 and March 31, 2021. Ambulatory COVID-19 patients treated with bamlanivimab (n = 209) were propensity score matched without replacement (1:1) to a pool of 1024 eligible control patients who received similar care without bamlanivimab. The primary endpoint was all-cause mortality or admission at 30 days. Secondary endpoints included hospitalization, critical care admission, oxygenation requirements, and infusion-related reactions. Propensity score matching (PSM) analysis was used to assess the effect of bamlanivimab infusion on the composite endpoint and secondary endpoints. Results: A total of n = 209 matched patients were included in each arm of the study. The absolute standardized difference (stddiff) was calculated and indicated a balance between the groups. Almost all variables had a stddiff of less than 0.10, except for respiratory rate (RR) (stddiff = -0.11). For the primary composite endpoint of the matched cohort, 10.1% (n = 21) of patients in the intervention group were hospitalized or deceased within 30-day postbamlanivimab infusion versus 27.8% (n = 58) in the control group (adjusted odds ratio [aOR]: 0.29, 95% confidence interval [CI]: 0.17 to 0.51, P < .001). Conclusion: Patients with ambulatory COVID-19 who received bamlanivimab in the outpatient setting had a statistically significant reduction on the odds of admission postinfusion. Despite bamlanivimab's lack of efficacy on newer SARS-CoV-2 variants, this study demonstrates that neutralizing monoclonal antibodies can be effective against specific variants. If variant identification becomes a more accessible tool in outpatient centers or EDs, more targeted therapeutic options may be considered.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 / Anticorpos Monoclonais Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 / Anticorpos Monoclonais Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article