Clinical Outcomes of Monoclonal Antibody Therapy During a COVID-19 Outbreak in a Skilled Nursing Facility - Arizona, 2021
et al., Journal of the American Geriatrics Society, doi:10.1111/jgs.17705, Feb 2022
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.
No treatment is 100% effective. Protocols
combine treatments.
6,300+ studies for
210+ treatments. c19early.org
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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.
Standard of Care (SOC) for COVID-19 in the study country,
the USA, is very poor with very low average efficacy for approved treatments6.
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.
This may explain in part the very high mortality seen in this study.
Results may differ in countries with improved SOC.
|
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.
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|
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.
|
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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 |
1.
Liu et al., Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2, bioRxiv, doi:10.1101/2021.12.14.472719.
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Sheward et al., Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron), bioRxiv, doi:10.1101/2021.12.19.473354.
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VanBlargan et al., An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies, bioRxiv, doi:10.1101/2021.12.15.472828.
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Pochtovyi et al., In Vitro Efficacy of Antivirals and Monoclonal Antibodies against SARS-CoV-2 Omicron Lineages XBB.1.9.1, XBB.1.9.3, XBB.1.5, XBB.1.16, XBB.2.4, BQ.1.1.45, CH.1.1, and CL.1, Vaccines, doi:10.3390/vaccines11101533.
Dale et al., 9 Feb 2022, retrospective, USA, peer-reviewed, 14 authors, average treatment delay 2.0 days.
Clinical outcomes of monoclonal antibody therapy during a COVID ‐19 outbreak in a skilled nursing facility—Arizona, 2021
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
References
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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
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