Real-world Assessment of 2,879 COVID-19 Patients Treated with Monoclonal Antibody Therapy: A Propensity Score-Matched Cohort Study

A c c e p t e d M a n u s c r i p t 14 Monoclonal antibodies are susceptible to the evolution of viral resistance mutations in target epitopes, and the EUA for bamlanivimab was revoked due to demonstrated resistance of emerging variants (https://www.fda.gov/media/147629/download). Similarly, the EUA for bamlanivimab and etesevimab was recently revoked (June 25, 2021), due to the increasing prevalence of the P.1 and B.1.351 variants (www.covid19.lilly.com/bam-ete) that have been shown to escape certain mAbs. 23, 26 Combination mAbs that bind non-overlapping epitopes reduce the risk of resistance and have a clear advantage, and continued monitoring and assessment of emerging variants and their susceptibility to natural or induced immunity and therapeutic antibodies remains crucial. In summary, our propensity score-matched analysis confirms that early infusion of neutralizing mAbs to COVID-19 patients significantly reduced hospitalization and mortality among a large cohort of high-risk individuals. These data support continued widespread efforts to make early passive immune therapy available to COVID-19 patients. Potential Conflicts of Interest All authors report no conflicts of interest related to this study. A c c e p t e d M a n u s c r i p t 15 The study was reviewed and approved by the Houston Methodist Research Institute Institutional Review Board (IRB PRO00029666). Given the study design, patient's written consent was not required. However, verbal and written..