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Clinical outcomes of monoclonal antibody therapy during a COVID‐19 outbreak in a skilled nursing facility—Arizona, 2021.
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- Author(s): Dale, Ariella P. (AUTHOR); Hudson, Matthew J. (AUTHOR); Armenta, Darunee (AUTHOR); Friebus, Heather (AUTHOR); Ellingson, Katherine D. (AUTHOR); Davis, Kat (AUTHOR); Cullen, Theresa (AUTHOR); Brady, Shane (AUTHOR); Komatsu, Kenneth K. (AUTHOR); Stone, Nimalie D. (AUTHOR); Uyeki, Timothy M. (AUTHOR); Slifka, Kara Jacobs (AUTHOR); Pérez‐Vélez, Carlos M. (AUTHOR); Keaton, Amelia A. (AUTHOR)
- Source:
Journal of the American Geriatrics Society. Apr2022, Vol. 70 Issue 4, p960-967. 8p. - Source:
- Additional Information
- Subject Terms:
- Abstract: Background: Adult residents of skilled nursing facilities (SNF) have experienced high morbidity and mortality from SARS‐CoV‐2 infection and are at increased risk for severe COVID‐19 disease. Use of monoclonal antibody (mAb) treatment improves clinical outcomes among high‐risk outpatients with mild‐to‐moderate COVID‐19, but information on mAb effectiveness in SNF residents with COVID‐19 is limited. We assessed outcomes in SNF residents with mild‐to‐moderate COVID‐19 associated with an outbreak in Arizona during January–February 2021 that did and did not receive a mAb. Methods: Medical records were reviewed to describe the effect of bamlanivimab therapy on COVID‐19 mortality. Secondary outcomes included referral to an acute care setting and escalation of medical therapies at the SNF (e.g., new oxygen requirements). Residents treated with bamlanivimab were compared to residents who were eligible for treatment under the FDA's Emergency Use Authorization (EUA) but were not treated. Multivariable logistic regression was used to determine association between outcomes and treatment status. Results: Seventy‐five residents identified with COVID‐19 during this outbreak met eligibility for mAb treatment, of whom 56 received bamlanivimab. Treated and untreated groups were similar in age and comorbidities associated with increased risk of severe COVID‐19 disease. Treatment with bamlanivimab was associated with reduced 21‐day mortality (adjusted OR = 0.06; 95% CI: 0.01, 0.39) and lower odds of initiating oxygen therapy (adjusted OR = 0.07; 95% CI: 0.02, 0.34). Referrals to acute care were not significantly different between treated and untreated residents. Conclusions: mAb therapy was successfully administered to SNF residents with COVID‐19 in a large outbreak setting. Treatment with bamlanivimab reduced 21‐day mortality and reduced initiation of oxygen therapy. As the COVID‐19 pandemic evolves and newer immunotherapies gain FDA authorization, more studies of the effectiveness of mAb therapies for treating emerging SARS‐CoV‐2 variants of concern in high‐risk congregate settings are needed. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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