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Curbing the Delta Surge: Clinical Outcomes After Treatment With Bamlanivimab-Etesevimab, Casirivimab-Imdevimab or Sotrovimab for Mild to Moderate Coronavirus Disease-2019

Open AccessPublished:June 22, 2022DOI:https://doi.org/10.1016/j.mayocp.2022.06.015
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      ABSTRACT

      Objective

      To describe and compare the clinical outcomes of bamlanivimab-etesevimab, casirivimab-imdevimab and sotrovimab treatment of mild to moderate coronavirus disease-2019 during the SARS-CoV-2 B.1.617.2 Delta surge.

      Methods

      Retrospective study of high-risk patients who received bamlanivimab-etesevimab, casirivimab-imdevimab and sotrovimab for mild to moderate COVID-19 during August 1 – December 1, 2021. Rates of severe disease, hospitalization, intensive care unit admission and death were assessed.

      Results

      Among 10,775 high-risk patients who received bamlanivimab-etesevimab, casirivimab-imdevimab or sotrovimab for mild to moderate COVID-19 during the Delta surge, 287 patients (2.7%) developed severe disease that led to hospitalization, oxygen supplementation or death within 30 days after treatment. The rates of severe disease were low among patients treated with bamlanivimab-etesevimab (1.2%), casirivimab-imdevimab (2.9%), and sotrovimab (1.6%; p<0.01). The higher rate of severe outcomes among patients treated with casirivimab-imdevimab may be related to a significantly lower COVID-19 vaccination rate in that cohort. Intensive care unit admission was comparable among patients treated with the anti-spike monoclonal antibody products (1.0%, 1.0%, 0.4%, respectively).

      Conclusion

      This real-world study of a large cohort of high-risk patients demonstrates low rates of severe disease, hospitalization, ICU admission, and mortality after treatment with bamlanivimab-etesevimab, casirivimab-imdevimab and sotrovimab for mild to moderate COVID-19 during the SARS-CoV-2 Delta surge.

      ABBREVIATIONS:

      BMI (body mass index), CI (confidence interval), COVID-19 (coronavirus disease-2019), EHR (electronic health record), EUA (emergency use authorization), FDA (Food and Drug Administration), ICU (intensive care unit), IQR (interquartile range), MASS (monoclonal antibody screening score), MATRx (Monoclonal Antibody Treatment Program), PCR (polymerase chain reaction), SARS-COV-2 (Severe Acute Respiratory Syndrome-coronavirus-2)