Impact of Rapidly Deployed COVID-19 Monoclonal Antibody Infusion Clinics on Rate of Hospitalization

Delasobera et al., Infectious Diseases in Clinical Practice, doi:10.1097/IPC.0000000000001109, Jan 2022
Mortality -119% improvement lower risk ← → higher risk Hospitalization 52% Progression 20% Bamlanivimab/e..  Delasobera et al.  EARLY TREATMENT Is early treatment with bamlanivimab/etesevimab beneficial? Retrospective 438 patients in the USA Lower hospitalization with bamlanivimab/etesevimab (p=0.014) c19early.org Delasobera et al., Infectious Diseases.., Jan 2022 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.
6,300+ studies for 210+ treatments. c19early.org
Meta Analysis
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 omicron1-5.
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.
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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.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org December 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 December 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%
Impact of Rapidly Deployed COVID-19 Monoclonal Antibody Infusion Clinics on Rate of Hospitalization
MD Bronson E Delasobera, MD Tara Saggar, MBA Jennifer N Goodwin, MS, PA-C, Amanda Joy, DNP Kiersten N Henry, Acnp-Bc, PharmD, MBA Bonnie Levin, MD David D Hager, MD Joel Mcalduff, PhD Sameer Desale, MHSA Xavier Owens, MD Glenn W Wortmann, MD Princy N Kumar
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.
References
Chen, Nirula, Heller, SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with COVID-19, N Engl J Med
Fineberg, Rapid Expert Consultation on Allocating COVID-19 Monoclonal Antibody Therapies and Other Novel Therapeutics, doi:10.17226/26063
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
Kumar, Wu, Stosor, Real-world experience of bamlanivimab for COVID-19: a case-control study, Clin Infect Dis, doi:10.1093/cid/ciab305
Weinreich, Sivapalasingam, Norton, REGN-COV2, a neutralizing antibody cocktail, in outpatients with COVID-19, N Engl J Med
Williamson, Tewarson, Increasing utilization of COVID-19 monoclonal antibodies: considerations and promising practices for states
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Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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