Abstract
Background: Mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reduce the efficacy of neutralizing monoclonal antibody therapy against coronavirus disease 2019 (COVID-19). We here evaluated the efficacy of casirivimab-imdevimab in patients with mild-to-moderate COVID-19 during the Delta variant surge in Fukushima Prefecture, Japan. Methods: We enrolled 949 patients with mild-to-moderate COVID-19 who were admitted to hospital between July 24, 2021 and September 30, 2021. Clinical deterioration after admission was compared between casirivimab-imdevimab users (n = 314) and non-users (n = 635). Results: The casirivimab-imdevimab users were older (P < 0.0001), had higher body temperature (≥ 38°C) (P < 0.0001) and greater rates of history of cigarette smoking (P = 0.0068), hypertension (P = 0.0004), obesity (P < 0.0001), and dyslipidemia (P < 0.0001) than the non-users. Multivariate logistic regression analysis demonstrated that receiving casirivimab-imdevimab was an independent factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.263-0.763; P = 0.0023). Furthermore, in 222 patients who were selected from each group after matching on the propensity score, deterioration was significantly lower among those receiving casirivimab-imdevimab compared to those not receiving casirivimab-imdevimab (7.66% vs 14.0%; p = 0.021). Conclusion: This real-world study demonstrates that casirivimab-imdevimab contributes to the prevention of deterioration in COVID-19 patients after hospitalization during a Delta variant surge.
Keywords: COVID-19; Delta variant; SARS-CoV-2; casirivimab-imdevimab; real-world effectiveness.
【저자키워드】 COVID-19, SARS-CoV-2, delta variant, casirivimab-imdevimab, real-world effectiveness., 【초록키워드】 coronavirus disease, Coronavirus disease 2019, Efficacy, coronavirus, therapy, Hospitalization, obesity, hospital, monoclonal antibody, Delta, smoking, severe acute respiratory syndrome Coronavirus, delta variant, hypertension, monoclonal antibody therapy, Deterioration, Casirivimab, Imdevimab, clinical, Patient, Effectiveness, Japan, Neutralizing, respiratory, Admission, body temperature, dyslipidemia, Propensity score, Odds ratio, COVID-19 patient, Clinical deterioration, Mild-to-moderate, cigarette smoking, acute respiratory syndrome, Older, Logistic regression analysis, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, 95% confidence interval, multivariate, multivariate logistic regression analysis, significantly lower, independent, greater, enrolled, selected, evaluated, receiving, contribute, demonstrated, reduce, Fukushima, 【제목키워드】 Treatment, pandemic, Clinical outcome, Patient, Mild-to-moderate,