The Efficacy of Bamlanivimab in Reducing Emergency Department Visits and Hospitalizations in a Real-world Setting

Abstract: Open Forum Infectious Diseases BRIEF REPORT The Efficacy of Bamlanivimab in Reducing Emergency Department Visits and Hospitalizations in a Real-world Setting Douglas S. Corwin,1 Peter T. Ender,2 Nitasa Sahu,1 Ryan A. Durgham,3 Dennis M. McGorry Jr.,4 Awan Rahman,1 Jill Stoltzfus,5 and Jeffrey A. Jahre2 1 Bamlanivimab, a monoclonal antibody targeting the spike protein of severe acute respiratory syndrome coronavirus 2, is available for ambulatory treatment of coronavirus disease 2019 (COVID19). This real-world study confirms the efficacy of bamlanivimab in reducing hospital admissions and emergency department visits among high-risk outpatients with mild to moderate COVID-19 illness and reveals a trend toward improved mortality. Keywords. bamlanivimab; COVID-19; treatment; outcomes. Limited ambulatory treatment options exist for coronavirus disease 2019 (COVID-19), the syndrome caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which contributes to the profound morbidity and mortality associated with this illness [1, 2]. The striking number of people afflicted with COVID-19 has resulted in a dramatic increase in health care resource requirements. More than a third of Americans live in locations with a critical bed shortage during a surge of cases of COVID-19, including metropolitan areas in the Middle Atlantic and Northeastern States [3]. This high degree of health care utilization has led to concerns about the quantity of resources available and ability to maintain a proper standard of care. In November 2020, bamlanivimab (LY-CoV555; Lilly), an IgG1 monoclonal antibody that binds to the receptor-binding Received 30 March 2021; editorial decision 1 June 2021; accepted 9 June 2021. Correspondence: D.S. Corwin, MD, St Luke’s University Health Network, 709 Delaware Ave, Fountain Hill, PA 18015 (douglas.corwin@sluhn.org). Open Forum Infectious Diseases®2021 © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com DOI: 10.1093/ofid/ofab305 METHODS St. Luke’s University Health Network (SLUHN) includes 12 hospitals, 76 primary care sites, and 18 urgent care centers in Eastern Pennsylvania and Western New Jersey. Testing for COVID-19 occurred at dedicated outpatient testing sites and emergency departments within the St. Luke’s Network. The analysis included patients treated with a single dose of 700 mg of bamlanivimab infused over 60 minutes from November 23, 2020, until January 17, 2021. Due to limited seat availability for infusion, in the setting of a large surge of patients in the region, only patients who were ≥65 years of age and/or had a BMI ≥35 with a positive COVID-19 test by polymerase chain reaction (PCR) within 7 days of symptoms received bamlanivimab treatment. One bamlanivimab infusion center is in Eastern Pennsylvania, and the other is in Western New Jersey. Referral for treatment was at the discretion of the primary care physician (PCP). A follow-up visit occurred 48 hours after the infusion with a PCP within SLUHN to..