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. 2021 May 17;8(7):ofab254.
doi: 10.1093/ofid/ofab254. eCollection 2021 Jul.

Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

J Ryan Bariola  1 , Erin K McCreary  1 , Richard J Wadas  2 , Kevin E Kip  3 , Oscar C Marroquin  3 , Tami Minnier  4 , Stephen Koscumb  3 , Kevin Collins  3 , Mark Schmidhofer  5 , Judith A Shovel  4 , Mary Kay Wisniewski  4 , Colleen Sullivan  6 , Donald M Yealy  2 , David A Nace  7 , David T Huang  2   8   9 , Ghady Haidar  1 , Tina Khadem  1 , Kelsey Linstrum  6   9 , Christopher W Seymour  2   6   9 , Stephanie K Montgomery  6   9 , Derek C Angus  6   8   9 , Graham M Snyder  1
Affiliations

Impact of Bamlanivimab Monoclonal Antibody Treatment on Hospitalization and Mortality Among Nonhospitalized Adults With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

J Ryan Bariola et al. Open Forum Infect Dis. .

Abstract

Background: Monoclonal antibody treatment may prevent complications of coronavirus disease 2019 (COVID-19). We sought to quantify the impact of bamlanivimab monoclonal antibody monotherapy on hospitalization and mortality among outpatients at high risk of COVID-19 complications.

Methods: In this observational study we compared outpatients who received bamlanivimab monoclonal antibody from December 9, 2020 to March 3, 2021 to nontreated patients with a positive polymerase chain reaction or antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the same period who were eligible for monoclonal antibody treatment. The primary outcome was 28-day hospitalization or all-cause mortality, and the secondary outcome was hospitalization or emergency department visit without hospitalization. The risk-adjusted odds of study outcomes comparing bamlanivimab treated and untreated patients was determined using 1:5 propensity matching and multivariable logistic regression.

Results: Among 232 patients receiving bamlanivimab matched with 1160 comparator patients, the mean age was 67 years, 56% were female, and 196 (14%) of patients experienced hospitalization or mortality. After adjustment for propensity to receive treatment, bamlanivimab treatment was associated with a significantly reduced risk-adjusted odds of hospitalization or mortality within 28 days (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.24-0.69; P < .001). Bamlanivimab treatment was also associated with a significantly lower risk adjusted odds of hospitalization or emergency department visit without hospitalization (OR, 0.54; 95% CI, 0.35-0.82; P = .004). The results were most strongly associated with patients age 65 years and older.

Conclusions: Bamlanivimab monoclonal antibody monotherapy was associated with reduced hospitalizations and mortality within 28 days among outpatients with mild to moderate COVID-19.Use of bamlanivimab monotherapy for outpatients with mild to moderate COVID-19 infection was associated with reductions in hospitalizations and mortality within 28 days. Benefit was strongest in those age 65 years or older.

Keywords: COVID-19; SARS-CoV-2; bamlanivimab; monoclonal antibodies.

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Figures

Figure 1.
Figure 1.
Frequency of 28-day study outcomes among propensity-matched patients receiving and not receiving bamlanivimab monoclonal antibody treatment. (a) depicts the frequency of 28-day hospitalization or mortality 408 (primary outcome) and hospitalization or emergency department (ED) visit without hospitalization (secondary outcome) among the matched patients receiving bamlanivimab monoclonal antibody treatment (orange bars) versus those not receiving bamlanivimab monoclonal antibody treatment (blue bars). (b) depicts the frequency of the individual elements of the composite primary and secondary outcomes. P values are from the matched cohort logistic regression models.
Figure 2.
Figure 2.
Frequency of 28-day study outcomes among patients receiving bamlanivimab monoclonal antibody treatment, stratified by timing of treatment. ED, emergency department.
See this image and copyright information in PMC

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