Early Treatment with Monoclonal Antibodies or Convalescent Plasma Reduces Mortality in Non-Vaccinated COVID-19 High-Risk Patients

Abstract

Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants.

Immunological and Neurological Changes of COVID-19 in the Elderly

“…Longer hospital stays led to more nosocomial infections, putting patients at a potential risk of further complications. 16 In general, elderly patients with COVID-19 have distinctive features. The atypical clinical presentation without fever and the most common features of delirium or neurological symptoms may delay diagnosis and increase the risk of mortality.…”

Therapeutic Effectiveness of Interferon-α2b against COVID-19 with Community-Acquired Pneumonia: The Ukrainian Experience

“…SARS-CoV-2-specific monoclonal antibodies and convalescent plasma represented another effective treatment strategy to protect at-risk patients, such as immunocompromised and elderly patients, from a severe or lethal course of infection [ 11 ]. However, the treatment effectiveness may vary depending on the predominant variant.…”

COVID-19 in der Intensivmedizin

“…B. Casirivimab plus Imdevimab, Regdanvimab, Bamlanivimab plus Etesevimab oder Sotrovimab) das Risiko von Krankenhausaufenthalten und Tod [ 33 , 34 ]. In unserer vulnerablen Kohorte von immunsupprimierten Patienten nach solider Organtransplantation beobachteten auch wir eine signifikante Verringerung des Risikos für schwere Krankheitsverläufe durch den Einsatz monoklonaler Antikörper, insbesondere in der Beta- und in der Deltawelle [ 35 ]. Nach Ablauf der ersten 7 Tage nach Symptombeginn oder wenn der Symptombeginn unklar ist, ist der Einsatz der monoklonalen Antikörpertherapie nur bei seronegativen Patienten gerechtfertigt.…”