Casirivimab–Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19
Raymund R Razonable, Colin Pawlowski, John C O'horo, Lori L Arndt, Richard Arndt, Dennis M Bierle, Molly Destro Borgen, Sara N Hanson, Michelle C Hedin, Patrick Lenehan, Arjun Puranik, Maria T Seville, Leigh L Speicher, Sidna M Tulledge-Scheitel, A J Venkatakrishnan, Caroline G Wilker, Andrew D Badley, Ravindra Ganesh
EClinicalMedicine, doi:10.1016/j.eclinm.2021.101102
Background: Real-world clinical data to support the use of casirivimabÀimdevimab for the treatment of outpatients with mild to moderate coronavirus disease-19 (COVID-19) is needed. This study aimed to assess the outcomes of casirivimabÀimdevimab treatment of mild to moderate COVID-19. Methods: A retrospective cohort of 696 patients who received casirivimabÀimdevimab between December 4, 2020 and April 9, 2021 was compared to a propensity-matched control of 696 untreated patients with mild to moderate COVID-19 at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin. Primary outcome was rate of hospitalization at days 14, 21 and 28 after infusion. Findings: The median age of the antibody-treated cohort was 63 years (interquartile range, 52À71); 45¢5% were 65 years old; 51.4% were female. High-risk characteristics were hypertension (52.4%), body mass index 35 (31.0%), diabetes mellitus (24.6%), chronic lung disease (22.1%), chronic renal disease (11.4%), congestive heart failure (6.6%), and compromised immune function (6.7%). Compared to the propensitymatched untreated control, patients who received casirivimabÀimdevimab had significantly lower all-cause hospitalization rates at day 14 (1.3% vs 3.3%; Absolute Difference: 2.0%; 95% confidence interval (CI): 0.5À3.7%), day 21 (1.3% vs 4.2%; Absolute Difference: 2.9%; 95% CI: 1.2À4.7%), and day 28 (1.6% vs 4.8%; Absolute Difference: 3.2%; 95% CI: 1.4À5.1%). Rates of intensive care unit admission and mortality at days 14, 21 and 28 were similarly low for antibody-treated and untreated groups. Interpretation: Among high-risk patients with mild to moderate COVID-19, casirivimabÀimdevimab treatment was associated with a significantly lower rate of hospitalization. Funding: Mayo Clinic.
Funding
Mayo Clinic
Contributors Concept and Design: Razonable, Pawlowski, Ganesh Acquisition, Analysis, or Interpretation of Data: Razonable, Pawlowski, Lenehan, Puranik, Venkatakrishnan, O'Horo, Badley, Ganesh Drafting of the Manuscript:
Supplementary materials Supplementary material associated with this article can be found in the online version at doi:10.1016/j.eclinm.2021.101102.
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