Effect of the Timing of Amubarvimab/Romlusevimab (BRII-196/198) Administration on Progression to Severe Disease in Elderly Patients with COVID-19 Infection: A Retrospective Cohort Study

Abstract

Objective Early intervention with neutralizing antibodies is considered to be effective in preventing disease progression in patients with mild to moderate COVID-19 infection. Elderly patients are the most susceptible and at a higher risk of COVID-19 infection. The present study aimed to assess the necessity and possible clinical benefits of the early administration of Amubarvimab/Romlusevimab (BRII-196/198) in the elderly population. Methods The present study was designed as a retrospective, multi-center cohort study conducted with 90 COVID-19 patients aged over 60, who were divided into two groups based on the timing of the administration of BRII-196/198 (administration at ≤ 3 days or > 3 days from the onset of infection symptoms). Results The ≤ 3 days group exhibited a greater positive effect (HR 5.94, 95% CI, 1.42–24.83; P < 0.01), with only 2 patients among 21 patients (9.52%) exhibiting disease progression, compared to the 31 patients among the 69 patients (44.93%) of the > 3 days group who exhibited disease progression. The multivariate Cox regression analysis revealed low flow oxygen support prior to BRII-196/198 administration (HR 3.53, 95% CI 1.42–8.77, P < 0.01) and PLT class (HR 3.68, 95% CI 1.37–9.91, P < 0.01) as independent predictors of disease progression. Conclusions In elderly patients with mild or moderate COVID-19 disease, who do not require oxygen support and had the risk factors for disease progression to severe COVID-19 disease, the administration of BRII-196/198 within 3 days resulted in a beneficial trend in terms of preventing disease progression.

Exploring the Relationship of Comorbidities, Smoking Status, HRCT Findings With COVID-19 Disease Severity and Outcomes

“…Early detection and prompt care are essential to reduce the risk of serious illnesses in the population. Elderly COVID-19 patients can benefit from close symptom monitoring, routine health checks, and quick medical interventions to reduce risk and improve results [10]. Similar to the results of the present study, elderly patients had poor outcomes.…”

“…Older patients are more vulnerable to and at risk of COVID-19. Their increased vulnerability is a result of age-related immune system changes, underlying medical problems, respiratory system abnormalities, and social factors [10]. Long-term medication for the treatment of comorbidities affects the cascade of COVID-19 symptoms and reduces the number of therapeutic options for the treatment of COVID-19 [11].…”

Evolution of the SARS-CoV-2 Omicron Variants: Genetic Impact on Viral Fitness

“…Regdanvimab, developed by Celltrion Inc. (Incheon, Republic of Korea), as well as the cocktail therapies Bamlanivimab/Etesevimab and Casirivimab/IImdevimab, developed by Eli Lilly and Regeneron respectively, have all forfeited their neutralization against BA.1 or BA.2. GSK’s Sotrovimab, and the cocktail therapies Amubarvimab/Romlusevimab (only approved in China, but both randomized controlled trials and real-world research robustly substantiate its clinical efficacy [ 64 , 65 , 66 ]) and Evusheld (Cilgavimab/Tixagevimab), developed by Brii Biosciences and AstraZeneca respectively, have also experienced varying degrees of decline in neutralizing activity, albeit still retaining some level of neutralization. In contrast, Eli Lilly’s Bebtelovimab, which gained approval after the appearance of Omicron on 11 February 2022, has demonstrated high-efficiency neutralizing activity against BA.1 and BA.2 [ 67 , 68 , 69 ].…”