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0 0.5 1 1.5 2+ Mortality 89% Improvement Relative Risk Progression 86% Progression (b) 54% Bamlanivimab/e..  Dale et al.  EARLY TREATMENT Is early treatment with bamlanivimab/etesevimab beneficial for COVID-19? Retrospective 75 patients in the USA Lower mortality (p=0.0097) and progression (p=0.0022) Dale et al., J. the American Geriatric.., Feb 2022 Favors bamlanivimab/e.. Favors control

Clinical Outcomes of Monoclonal Antibody Therapy During a COVID-19 Outbreak in a Skilled Nursing Facility - Arizona, 2021

Dale et al., Journal of the American Geriatrics Society, doi:10.1111/jgs.17705
Feb 2022  
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20th treatment shown to reduce risk in May 2021
*, now known with p = 0.00029 from 20 studies, recognized in 4 countries. Efficacy is variant dependent.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Retrospective 75 COVID+ patients in a skilled nursing facility in the USA, 56 treated within a median of 2 days from symptom onset with bamlanivimab, showing significantly lower mortality with treatment.
Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron Haars, Liu, Pochtovyi, Sheward, VanBlargan.
risk of death, 89.2% lower, RR 0.11, p = 0.010, treatment 5 of 56 (8.9%), control 9 of 19 (47.4%), NNT 2.6, adjusted per study, odds ratio converted to relative risk, multivariable.
risk of progression, 86.3% lower, RR 0.14, p = 0.002, treatment 6 of 56 (10.7%), control 10 of 19 (52.6%), NNT 2.4, adjusted per study, odds ratio converted to relative risk, oxygen therapy, multivariable.
risk of progression, 53.8% lower, RR 0.46, p = 0.35, treatment 6 of 56 (10.7%), control 3 of 19 (15.8%), adjusted per study, odds ratio converted to relative risk, ER visit or hospitalization, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Dale et al., 9 Feb 2022, retrospective, USA, peer-reviewed, 14 authors, average treatment delay 2.0 days.
This PaperBamlaniv../e..All
Clinical outcomes of monoclonal antibody therapy during a COVID ‐19 outbreak in a skilled nursing facility—Arizona, 2021
PhD, MPH Ariella P Dale, MD, MPH Matthew J Hudson, RN Darunee Armenta, RD, LNHA Heather Friebus, PhD Katherine D Ellingson, MPH Kat Davis, MD Theresa Cullen, MPH Shane Brady, MPH Kenneth K Komatsu, MD Nimalie D Stone, MD Timothy M Uyeki, Kara Jacobs Slifka, Carlos M Pérez‐vélez, MD Amelia A Keaton
Journal of the American Geriatrics Society, doi:10.1111/jgs.17705
 Receipt of monoclonal antibody therapy significantly reduced odds of mortality and need for supplemental oxygen in skilled nursing facility residents with mild-to-moderate COVID-19.  Use of monoclonal antibody therapy in skilled nursing facilities requires close partnership with local health departments and healthcare entities Why does this paper matter? This paper describes the use of monoclonal antibody therapy in the setting of a COVID-19 outbreak at a skilled nursing facility. Additionally, this paper reaffirms that use of monoclonal antibody therapies in persons with mild-to-moderate COVID-19 prevents severe outcomes such as death.
Author contributions: All authors contributed to conception of this manuscript, and from that start point, shared in writing and revision process. Sponsors Role: No funding was received associated with this manuscript. There were no sponsors involved in the conceptualization or production of this manuscript. Accepted Article This article is protected by copyright. All rights reserved. N/A cannot be calculated due too few of observations. Accepted Article Accepted Article
Alam, Mahmud, Aggarwal, Clinical Impact of the Early Use of Monoclonal Antibody LY-CoV555 (Bamlanivimab) on Mortality and Hospitalization Among Elderly Nursing Home Patients: A Multicenter Retrospective Study, Cureus, doi:10.7759/cureus.14933
Bagchi, Mak, Li, Rates of COVID-19 among residents and staff members in nursing homes-United States, Morbidity and Mortality Weekly Report
Bariola, Mccreary, Wadas, Impact of monoclonal antibody treatment on hospitalization and mortality among non-hospitalized adults with SARS-CoV-2 infection
Cdc, SARS-CoV-2 Variant Classifications and Definitions
Cohen, Nirula, Mulligan, Effect of Bamlanivimab vs Placebo on Incidence of COVID-19 Among Residents and Staff of Skilled Nursing and Assisted Living Facilities: A Randomized Clinical Trial, JAMA, doi:10.1001/jama.2021.8828
Dale, Hudson, Cullen, Administration of Bamlanivimab to Skilled Nursing Facility Residents during a COVID-19 Outbreak, Journal of the American Medical Directors Association
Garg, Kim, Whitaker, Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019-COVID-NET, 14 States
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
Harris, Taylor, Minor, The REDCap consortium: Building an international community of software platform partners, Journal of biomedical informatics
Harris, Taylor, Thielke, Payne, Gonzalez et al., A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform
Hoffmann, Arora, Groß, SARS-CoV-2 variants B. 1.351 and P. 1 escape from neutralizing antibodies, Cell
Hosmer, Lemesbow, Goodness of fit tests for the multiple logistic regression model, Communications in statistics-Theory and Methods
Ko, Danielson, Town, Risk factors for COVID-19-associated hospitalization: COVID-19-associated hospitalization surveillance network and behavioral risk factor surveillance system
Kumar, Wu, Stosor, Real-World Experience of Bamlanivimab for COVID-19: A Case-Control Study, Clinical Infectious Diseases
Mcmichael, Currie, Clark, Epidemiology of Covid-19 in a long-term care facility in King County, Washington, New England Journal of Medicine
Patel, Chaisson, Borgetti, Asymptomatic SARS-CoV-2 infection and COVID-19 mortality during an outbreak investigation in a skilled nursing facility, Clinical Infectious Diseases
Williamson, Walker, Bhaskaran, Factors associated with COVID-19-related death using OpenSAFELY, Nature
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