Use of casirivimab and imdevimab to prevent progression to severe COVID-19

DOI record: { "DOI": "10.4103/jimph.jimph_23_24", "ISSN": [ "2949-7248", "2949-7256" ], "URL": "http://dx.doi.org/10.4103/JIMPH.JIMPH_23_24", "abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>BACKGROUND:</jats:title>\n <jats:p>Advanced age and the presence of comorbid illnesses increase the risk of disease progression and death in patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Several neutralizing antibodies against SARS-CoV2 have been developed for the management of mild to moderate coronavirus disease 2019 (COVID-19) at risk of disease progression. This study aimed to evaluate the effect of a combination of casirivimab and imdevimab (REGN-COV2) on disease progression/hospitalization in mild-to-moderate COVID-19.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>MATERIALS AND METHODS:</jats:title>\n <jats:p>It is a prospective interventional study, patients with mild-to-moderate COVID-19 were included in the study. The illnesses with risk factors for disease progression were divided into two groups, one who received a combination of casirivimab and imdevimab (REGN-COV2) cocktail and the other who received usual care. The primary outcome of the study was a comparison of disease progression or hospitalization on day 14 after treatment. Secondary outcomes included viral clearance, mortality, and effect on proinflammatory markers.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>RESULTS:</jats:title>\n <jats:p>A total of 169 patients with mild-to-moderate COVID-19 illness with risk factors for disease progression were included in the study. About 85 patients (50.3%) as cases received REGN-COV2 whereas 84 (49.7%) as control received usual care only. Hospitalization or progression of disease was significantly lower in patients who received REGN-COV2 than in the usual care only [14.12% vs. 27.38%; relative risk (RR) = 0.51, 95% confidence interval (CI) = 0.27−0.95, <jats:italic toggle=\"yes\">P</jats:italic> = 0.03]. Time taken for viral clearance was again lower in intervention group [median = 9 days, interquartile range (IQR) = [8–11] vs. median =13 days, IQR [10–14], <jats:italic toggle=\"yes\">P</jats:italic> &lt; 0.001] as was serum levels of C-reactive protein (CRP) and interleukin (IL)-6 significantly reduced in patients who received REGN-COV2 [CRP, median = 11.5 (5.75–34) to 4 (2–9), <jats:italic toggle=\"yes\">P</jats:italic> = 0.001 and IL-6, median 10 (4–23.5) to 3 (2–7), <jats:italic toggle=\"yes\">P</jats:italic> = 0.001]. Three patients in the usual care group died due to worsening respiratory failure compared with none in the REGN-COV2 group. Only minor adverse events were noticed in 8.2% (<jats:italic toggle=\"yes\">n</jats:italic> = 7) patients in the REGN-COV2 group with no life-threatening events observed.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>CONCLUSION:</jats:title>\n <jats:p>In mild-to-moderate COVID-19 patients at high risk of disease progression REGN-COV2 treatment significantly reduced progression of disease and hospitalization without significant adverse events.</jats:p>\n </jats:sec>", "assertion": [ { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Received", "name": "received", "value": "2024-11-07" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Accepted", "name": "accepted", "value": "2024-12-16" } ], "author": [ { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Shahnawaz", "given": "Mir", "sequence": "first" }, { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Hussain", "given": "Tajamul", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Firdous", "given": "Naeem", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Yousoof", "given": "Mohammad", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Gundroo", "given": "Hafsa M.", "sequence": "additional" }, { "affiliation": [ { "name": "Jammu Kashmir Medical Supplies Council Ltd., Srinagar, Jammu and Kashmir, India" } ], "family": "Sharma", "given": "YashPal", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pulmonary Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India" } ], "family": "Shah", "given": "Naveed Nazir", "sequence": "additional" } ], "container-title": "Journal of Integrative Medicine and Public Health", "container-title-short": "J Integr Med Public Health", "content-domain": { "crossmark-restriction": true, "domain": [ "lww.com", "ovid.com" ] }, "created": { "date-parts": [ [ 2025, 1, 20 ] ], "date-time": "2025-01-20T06:00:35Z", "timestamp": 1737352835000 }, "deposited": { "date-parts": [ [ 2025, 1, 20 ] ], "date-time": "2025-01-20T06:00:40Z", "timestamp": 1737352840000 }, "indexed": { "date-parts": [ [ 2025, 1, 21 ] ], "date-time": "2025-01-21T05:03:28Z", "timestamp": 1737435808312, "version": "3.33.0" }, "is-referenced-by-count": 0, "issue": "2", "issued": { "date-parts": [ [ 2024, 7 ] ] }, "journal-issue": { "issue": "2", "published-print": { "date-parts": [ [ 2024 ] ] } }, "language": "en", "license": [ { 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