Optimal Time Identified for Monoclonal Antibody Infusions in Patients With COVID-19

The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.

Patients with mild –or moderate COVID-19 who received a monoclonal antibody (mAb) infusion within the first 5 days of symptom onset experienced decreased disease progression compared with those who received the infusion after 6 or more days, according to results of a single-center retrospective case-control study presented at IDWeek, held virtually from September 29 to October 3, 2021.

Investigators performed a risk factor analysis on the composite outcome of subsequent evaluation of patients with SARS-CoV-2 infection who hospitalized or admitted to the emergency department (ED) and treated with mAbs between December 2020 and May 2021. They performed multivariate and univariate analyses to find significant variables.

Among a total of 288 patients included in the analysis, the mean age was 58.6 years, 59.7% were female, 64.9% were White, and 27.1% were Black.

Following mAb treatment, 31 (10.8%) patients required treatment in the ED or hospitalization due to disease progression. Patients who received early (days 1-5 of symptom onset) mAb infusion had a decreased risk for disease progression compared with those who received late (days 6-12 of symptom onset) mAb infusion (6.1% vs 13.2%; P =.048).

Of 21 patients who received mAb infusion between days 1 and 3 following symptom onset, none experienced disease progression.

Patients with certain comorbidities were more likely to have disease progression, including those with congestive heart failure (P =.038), cirrhosis (P =.012), chronic kidney disease (CKD) (P =.001), and hypertension (P =.021). No differences in disease progression were observed in regard to sex, ethnicity, BMI, or symptoms between the treatment groups.

A multivariate analysis showed an increased risk for disease progression among patients with cirrhosis (odds ratio [OR], 3.0; 95% CI, 1.1-7.9) and CKD (OR, 2.6; 95% CI, 1.0-6.4); however, early mAb infusion was found to decrease the risk for disease progression (OR, 0.38; 95% CI, 0.14-1.0).

“Efforts should be made to infuse high risk patients with COVID-19 mAb therapy within 5 days of symptom onset,” the investigators concluded.

Reference

Abusalem L, Wood C, Crescencio JCR, Dare RK. Risk factor analysis for hospital admission following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) monoclonal antibody treatment. Presented at: IDWeek; September 29 to October 3, 2021. Poster 519.

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