Abstract
Background: Monoclonal antibodies (mAb) prevent COVID-19 progression when administered early. We compared mAb treatment outcomes among vaccinated and unvaccinated patients during Delta wave and assessed the feasibility of implementing stricter eligibility criteria in the event of mAb scarcity.
Methods: We conducted a retrospective observational study of casirivimab/imdevimab recipients with mild-to-moderate COVID-19 infection in an emergency department or outpatient infusion center (July 1-August 20, 2021). Primary outcome was all-cause hospital admission within 30 days post-treatment between vaccinated vs. unvaccinated patients during Delta surge in the Bronx, NY.
Results: A total of 250 patients received casirivimab/imdevimab (162 unvaccinated vs. 88 vaccinated). The median age was 39 years for unvaccinated patients, and 52 years for vaccinated patients (p < 0.0001). The median number of EUA criteria met was 1 for unvaccinated and 2 for vaccinated patients (p < 0.0001). Overall, 6% (15/250) of patients were admitted within 30 days post-treatment. Eleven unvaccinated patients (7%) were admitted within 30-days compared to 4 (5%) vaccinated patients (p = 0.48).
Conclusions: All-cause 30-day admission was not statistically different between vaccinated and unvaccinated patients. When federal allocation of therapies is limited, programs must prioritize patients at highest risk of hospitalization and death regardless of vaccination status.
Keywords: COVID-19; Casirivimab/imdevimab; Coronavirus disease 19; Delta variant; Monoclonal antibody; SARS-CoV-2 variant B.1.617.2; Unvaccinated; Vaccinated; Vaccination.
【저자키워드】 COVID-19, vaccination, monoclonal antibody, delta variant, unvaccinated, coronavirus disease 19, casirivimab/imdevimab, SARS-CoV-2 variant B.1.617.2, Vaccinated, 【초록키워드】 coronavirus disease, coronavirus, Treatment outcome, vaccination, therapy, Hospitalization, antibody, feasibility, monoclonal antibody, SARS-CoV-2 variant, Delta, B.1.617.2, risk, outcome, delta variant, monoclonal antibodies, observational study, EUA, emergency department, COVID-19 infection, Casirivimab, Imdevimab, Patient, death, Hospital admission, eligibility criteria, disease, Admission, patients, mAb, retrospective, Mild-to-moderate, criteria, Vaccination Status, Delta wave, COVID-19 progression, Primary outcome, median age, recipient, Administered, Prevent, highest, conducted, median, statistically, 【제목키워드】 Patient, assessment, retrospective, treated,