Impact of early versus late administration of bamlanivimab on readmissions in patients with high-risk COVID-19

Recombinant monoclonal antibody therapies have been utilized under emergency use authorization (EUA) for the prevention of clinical decompensation in high-risk COVID-19 positive patients for up to 10 days from symptom onset. The purpose of this study was to determine the impact of the timing of the...

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Bibliographic Details
Published in:	The American journal of emergency medicine Vol. 50; pp. 437 - 441
Main Authors:	Melton, James D., Wilson, Kayla, Blind, Fred, Barbera, Andrew, Bhisitkul, Donna, Hasara, Shannon, Homa, Karen, Karp, Juliana, Escowitz, Hal, Haber, Todd, DeGroot, Diana, Anderson, Jonathan, DeLeon, Jason, Santos, Jesse De Los, Faviere, Donna, Fuell, Joanne, Gillespie, Rita, Glueck, Jesse, Reeber, Cliff, Rhodes, David J., Rodriguez, Vashun
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-12-2021 Elsevier Limited
Subjects:	Adolescent Adult Age Age Factors Aged Antibodies, Monoclonal, Humanized - administration & dosage Antibodies, Neutralizing - administration & dosage Antiviral Agents - administration & dosage Bamlanivimab Body Mass Index Clinical outcomes Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - mortality COVID-19 Drug Treatment Demographics Drug Administration Schedule Electronic health records Emergency medical care Emergency Service, Hospital Female High-risk COVID-19 Hospital Mortality Hospitalization Hospitals Humans Illnesses Immunotherapy Length of Stay Male Medical records Middle Aged Monoclonal antibodies Monoclonal antibody therapy Mortality Oxygen saturation Pandemics Patient Readmission Patients Retrospective Studies Risk Factors Severe acute respiratory syndrome coronavirus 2 Statistical analysis Treatment Outcome Young Adult COVID-19 Bamlanivimab High-risk COVID-19 Monoclonal antibody therapy
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Summary:	Recombinant monoclonal antibody therapies have been utilized under emergency use authorization (EUA) for the prevention of clinical decompensation in high-risk COVID-19 positive patients for up to 10 days from symptom onset. The purpose of this study was to determine the impact of the timing of the monoclonal antibody, bamlanivimab, on clinical outcomes in high-risk COVID-19 positive patients. This was an IRB-approved, retrospective evaluation of adult patients who received bamlanivimab per EUA criteria in the emergency department (ED). Patients were dichotomized into two groups– 3 days of symptoms or less (early) versus 4 to 10 days (late). The primary outcome was hospitalization for COVID-related illness at 28 days (or treatment failure). Secondary outcomes were COVID-related ED visits at 28 days, hospital and intensive care unit (ICU) length of stay (LOS), and in-hospital mortality at 28 days. A total of 839 patients were included in the analysis. There was no difference observed in COVID-related hospitalization rates within 28 days between the early and late bamlanivimab administration groups (7.5% vs. 8.2%, p = 0.71). There was no difference in COVID-related ED visits within 28 days with 13% of patients returning to the ED. In conclusion, there were no differences in the rates of hospitalization at 28 days when bamlanivimab was administered in the first 3 days of illness versus days 4 to 10. Future prospective studies are warranted to expand upon the characteristics of patients that may or may not benefit from monoclonal antibody therapy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0735-6757 1532-8171
DOI:	10.1016/j.ajem.2021.08.032