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

Corwin et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab305, Jun 2021
Mortality 80% improvement lower risk ← → higher risk Hospitalization 39% Bamlanivimab/e..  Corwin et al.  EARLY TREATMENT Is early treatment with bamlanivimab/etesevimab beneficial? Retrospective 6,117 patients in the USA (November 2020 - January 2021) Lower hospitalization with treatment (p=0.00044) c19early.org Corwin et al., Open Forum Infectious D.., Jun 2021 0 0.5 1 1.5 2+ RR
25th treatment shown to reduce risk in May 2021, now with p = 0.00049 from 22 studies, recognized in 11 countries. Efficacy is variant dependent.
Lower risk for mortality, hospitalization, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
Download Meta Analysis
Retrospective 780 bamlanivimab patients and 5,337 patients not receiving treatment, showing lower hospitalization and ER visits with treatment.
Confounding by treatment propensity. This study analyzes a population where only a fraction of eligible patients received the treatment. Patients receiving treatment may be more likely to follow other recommendations, more likely to receive additional care, and more likely to use additional treatments that are not tracked in the data (e.g., nasal/oral hygiene1,2, vitamin D3, etc.) — either because the physician recommending bamlanivimab/etesevimab also recommended them, or because the patient seeking out bamlanivimab/etesevimab is more likely to be familiar with the efficacy of additional treatments and more likely to take the time to use them. Therefore, these kind of studies may overestimate the efficacy of treatments.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron4-8.
Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments9. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
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risk of death, 80.5% lower, RR 0.20, p = 0.08, treatment 1 of 780 (0.1%), control 35 of 5,337 (0.7%), NNT 190.
risk of hospitalization, 39.4% lower, RR 0.61, p < 0.001, treatment 57 of 780 (7.3%), control 490 of 5,337 (9.2%), odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Corwin et al., 10 Jun 2021, retrospective, USA, peer-reviewed, 8 authors, study period 23 November, 2020 - 17 January, 2021. Contact: douglas.corwin@sluhn.org.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR USA favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria USA favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
The Efficacy of Bamlanivimab in Reducing Emergency Department Visits and Hospitalizations in a Real-world Setting
MD Douglas S Corwin, Peter T Ender, Nitasa Sahu, Ryan A Durgham, Dennis M Mcgorry Jr, Awan Rahman, Jill Stoltzfus, Jeffrey A Jahre
Open Forum Infectious Diseases, doi:10.1093/ofid/ofab305
Bamlanivimab, a monoclonal antibody targeting the spike protein of severe acute respiratory syndrome coronavirus 2, is available for ambulatory treatment of coronavirus disease 2019 . 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.
Author contributions. D.S.C., P.E., N.S., R.D., and J.S. drafted the initial manuscript. All authors reviewed, contributed to the revision and approved the final manuscript. D.S.C. had full access to manuscript and final responsibility to submit for publication.
References
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Chen, Nirula, Heller, BLAZE-1 Investigators. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19, N Engl J Med
Goldhill, Hospitals in half the states are facing a massive staffing shortage, STAT
Gottlieb, Nirula, Chen, Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial, JAMA
Gottlieb, Nirula, Chen, Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial, JAMA
Halpin, Criner, Papi, Global initiative for the diagnosis, management, and prevention of chronic obstructive lung disease. The 2020 GOLD Science Committee report on COVID-19 and chronic obstructive pulmonary disease, Am J Respir Crit Care Med
Jorden, Rudman, Evidence for limited early spread of COVID-19 within the United States, MMWR Morb Mortal Wkly Rep
Kane, Shamliyan, Mueller, Nurse staffing and quality of patient care, Evid Rep Technol Assess (Full Rep)
Leatherby, Keefe, Tompkins, There's no place for them to go': I.C.U. beds near capacity across U.S. The New York Times
O'hearn, Liu, Cudhea, Coronavirus disease 2019 hospitalizations attributable to cardiometabolic conditions in the United States: a comparative risk assessment analysis, J Am Heart Assoc
Wang, Nair, Liu, Increased resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7 to antibody neutralization
Wickham, R packages for data science
Widera, Wilhelm, Hoehl, Bamlanivimab does not neutralize two SARS-CoV-2 variants carrying E484K in vitro
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