Clinical Impact of the Early Use of Monoclonal Antibody LY-CoV555 (Bamlanivimab) on Mortality and Hospitalization Among Elderly Nursing Home Patients: A Multicenter Retrospective Study

Abstract

Importance Coronavirus disease 2019 (COVID-19) outbreaks are frequent occurrences in nursing homes and long-term care facilities (LTCFs), resulting in subsequent hospitalization and death. Rationale Virus-neutralizing monoclonal antibodies demonstrate a significant decrease in both viral load and hospital transfer rate among patients with mild-to-moderate COVID-19 infection. Objective To assess the clinical outcomes of COVID-19 patients with mild-to-moderate symptoms in LTCFs who received LY-CoV555 as compared to those who did not receive this treatment. Design Retrospective case-control study and logistic regression analysis. Setting LTCFs in New York. Participants Two-hundred forty-six (246) LTCF patients diagnosed with mild-to-moderate COVID-19 infection with positive COVID-19 polymerase chain reaction (PCR) from November 15, 2020, to January 31, 2021. Methods Two-hundred forty-six (246) COVID-19 patients were identified from electronic medical records, out of which 160 cases were exposed to LY-CoV555 treatment (700 mg single dose, intravenous infusion). Eighty-six (86) patients were unexposed controls who did not receive monoclonal antibodies, LY-CoV555. Outcome We assessed the odds of death and hospitalization of exposed cases as compared to unexposed controls. Using logistic regression analysis, we also assessed the risk factors associated with these outcomes in the entire sample population. Results The mean age of the entire sample was 82.4 years. Fifty-two percent (52%) of patients (n = 129) were female and 48% (n = 117) were male. The mean ages of the exposed group and the unexposed group were 81 years and 84 years, respectively. At the end of the study, 92% (148/160) of the exposed group were alive or not transferred to the hospital as compared to 79% (68/86) patients of the unexposed group (OR 3.23, 95% CI: (1.48, 7.31), p-value = 0.0032). Three percent (3%; 5/160) of patients died in the exposed group compared to 10% (9/86) of patients who died in the unexposed group (OR = 0.25, 95% CI: (0.1, 0.85), p-value = 0.0257). Four point thirty-seven percent (4.37%; 7/160) of patients in the exposed group and 10.46% (9/86) of patients in the unexposed group were transferred to the hospital (OR = 0.35, 95% CI: (0.15, 1.08), p-value = 0.0793). Conclusion Early treatment with monoclonal antibody LY-CoV555 is associated with decreased mortality among high-risk patients with mild-to-moderate COVID-19 infection in LTCFs. Although not statistically significant, there was a trend towards a lower risk of hospitalization in patients treated with LY-CoV555.

Early Administration of Bamlanivimab in Combination with Etesevimab Increases the Benefits of COVID-19 Treatment: Real-World Experience from the Liguria Region

“…To the best of our knowledge, this study is the first to report the clinical use of bamlanivimab together with etesevimab in daily clinical practice, a few months after the drugs have been introduced in Italy. In our experience, the rate of hospital admission after BEC infusion was low (11.0%) and similar to the results obtained in other previous clinical experiences focusing on bamlanivimab alone, in which the percentage of hospital admission was reported to be up to 10% of the cases [20][21][22][23]. The reduction in the need for subsequent health resource utilization remained low despite the higher proportion of older persons with comorbidities included in the present study [20][21][22][23].…”

“…Previous studies evaluating bamlanivimab and etesevimab administered together have demonstrated that such combination significantly decreased SARS-CoV-2 log viral load as well as the need for hospital admission [12,13], leading to their approval from the EUA by the Food and Drug Administration for the treatment of mild and moderate COVID-19 in the outpatient setting [16]. Nevertheless, post-marketing information is very scarce [19][20][21][22][23], and at present, data regarding the correct timing for BEC infusion are lacking.…”

Bamlanivimab improves hospitalization and mortality rates in patients with COVID-19: A systematic review and meta-analysis

“…48 studies were identified for full-text review and 40 studies were excluded because they had no comparison groups between Bamlanivimab treatment and control or outcomes were not available. A total of 8 studies [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] comprising of 13573 adult patients with COVID-19, including 4191 in the BAM (administered alone) and 9382 in the control group arm, were included in this meta-analysis.…”

COVID-19 monoclonal antibody treatment impact on symptoms and post-COVID conditions among high-risk patients at a Federally Qualified Health Center

“…While evidence supports the effectiveness of mAbs at reducing hospitalization and mortality rates in real-world settings, most studies have focused on clinical outcomes rather than patient-centric outcomes such as symptom burden [ 5 – 8 , 10 , 11 , 32 – 34 ]. Findings are mixed regarding symptom burden over time, with several studies reporting a reduction in symptom duration or time to symptom resolution with mAbs but another study reporting that mAbs did not shorten symptom duration [ 35 – 37 ].…”