Impact of Rapidly Deployed COVID-19 Monoclonal Antibody Infusion Clinics on Rate of Hospitalization
Delasobera et al.
, Impact of Rapidly Deployed COVID-19 Monoclonal Antibody Infusion Clinics on Rate of Hospitalization
, Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001109
Retrospective 438 patients in the USA, 253 treated with bamlanivimab, showing significantly lower hospitalization with treatment.Efficacy is highly variant dependent. In Vitro research suggests a lack of efficacy for omicron [Liu, Sheward, VanBlargan].
risk of death, 119.4% higher, RR 2.19, p = 0.64, treatment 3 of 253 (1.2%), control 1 of 185 (0.5%).
risk of hospitalization, 52.2% lower, RR 0.48, p = 0.01, treatment 17 of 253 (6.7%), control 26 of 185 (14.1%), NNT 14.
risk of progression, 19.9% lower, RR 0.80, p = 0.52, treatment 23 of 253 (9.1%), control 21 of 185 (11.4%), NNT 44, ER followup visit.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Delasobera et al., 27 Jan 2022, retrospective, USA, peer-reviewed, 12 authors.
Abstract: ORIGINAL ARTICLE
Impact of Rapidly Deployed COVID-19 Monoclonal Antibody
Infusion Clinics on Rate of Hospitalization
Bronson E. Delasobera, MD,* Tara Saggar, MD,* Jennifer N. Goodwin, MBA,* Amanda Joy, MS, PA-C,*
Kiersten N. Henry, DNP, ACNP-BC,* Bonnie Levin, PharmD, MBA,* David D. Hager, MD,*
Joel McAlduff, MD,* Sameer DeSale, PhD,* Xavier Owens, MHSA,*
Glenn W. Wortmann, MD,† and Princy N. Kumar, MD‡
Background: Providing monoclonal antibody therapy infusions requires
challenging logistics, resources, and technology, hindering availability
across the United States. Early identification and treatment of COVIDpositive patients can reduce hospitalizations.
Objective: This study aimed to describe the referral, selection process,
and deployment of outpatient monoclonal infusion clinics, as well as the
impact of monoclonal antibody therapy in COVID-positive patients on
the rate of emergency department (ED) visits and hospitalization.
Methods: This is a retrospective cohort study that used screening of all
COVID-positive ambulatory patients using a unique scoring rubric embedded in the emergency medical response for appropriateness for therapy between November 2020 and January 2021. Participants included all outpatients testing positive for COVID-19 were screened, and those eligible were
referred for treatment with bamlanivimab. Of the 443 patients referred for
treatment, 252 patients were treated with bamlanivimab compared with
191 patients who declined treatment. Patients were treated either in 1 of
the 2 outpatient infusion centers (74%) or the ED (26%.)
Results: Of 443 patients with positive COVID-19 diagnoses who were
eligible for treatment based on a risk assessment rubric, 252 received
bamlanivimab. There was a significant reduction in hospitalization of
the treatment versus control group (6.7% vs 13.6%, P < 0.05). No significant differences were noted in risk score at screening, ED visits after infusion, days of symptom onset at screening or infusion, or death.
Conclusions and Relevance: The efficacy of monoclonal antibody
therapy on reducing hospitalization was demonstrated. Rapid development
of screening technology, scheduling and operational logistics, and physical
space can overcome the challenges in the current environment.
Key Words: COVID-19, monoclonal antibody therapy, infusion
(Infect Dis Clin Pract 2022;30: e1109)
major focus of the initial treatment of COVID-19 was to limit
disease progression in the inpatient setting. However, as the
pandemic progressed, the need for outpatient treatment options became apparent. In November 2020, the Food and Drug Administration
From the *MedStar Health; †MedStar Washington Hospital Center; and ‡Georgetown
University Medical Center, Washington, DC.
Correspondence to: Princy N. Kumar, MD, Georgetown University School of
Medicine, 5th Floor PHC Building, 3800 Reservoir Rd NW, Washington,
DC 20007. E‐mail: email@example.com.
B.E.D., T.S., J.N.G., A.J., K.N.H., B.L., D.D.H., J.M., S.D., X.O., and G.W.W.
report no conflicts of interest. P.N.K. reports receipt of grants/research
supports from Eli Lilly, Merck, Gilead, and GSK; reports receipt of honoraria
or consultation fees from Gilead, GSK, Merck, and AMGEN; and is a stock
shareholder of Pfizer, Johnson & Johnson, Gilead, Merck, and GSK.
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