Our data suggest that NUTRIC is superior to NRS 2002 for assessing malnutrition risk in ICU patients. Randomized, controlled studies are needed to determine whether nutrition interventions, stratified by NUTRIC score, can improve patient outcomes.

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Key Points Question Is subcutaneous treatment with casirivimab and imdevimab associated with improved 28-day clinical outcomes compared with nontreatment, and is it clinically similar to intravenously administered casirivimab and imdevimab for outpatients with COVID-19? Findings In this cohort study of 1959 propensity-matched outpatients with mild to moderate COVID-19 symptoms, the 28-day rate of hospitalization or death was 3.4% vs 7.0% for those receiving subcutaneous treatment vs nontreatment. In a second cohort analysis of 2185 outpatients, the 28-day rate of hospitalization or death was 2.8% vs 1.7% for subcutaneous vs intravenous treatment. Meaning Subcutaneous casirivimab and imdevimab was associated with reduced hospitalization and death compared with nontreatment and showed similar outcomes compared with intravenous casirivimab and imdevimab in outpatients with COVID-19.

DESIGN, SETTING, AND PARTICIPANTSThis study comprised 2 parallel studies: (1) a propensity score-matched cohort study of mAb treatment vs no mAb treatment and (2) a randomized comparative effectiveness trial of casirivimab-imdevimab and sotrovimab. The cohort consisted of patients who received mAb treatment at the University of Pittsburgh Medical Center outpatient infusion centers and emergency departments from July 14 to September 29, 2021. Participants were patients with a positive SARS-CoV-2 test result who were eligible to receive mAbs according to emergency use authorization criteria.EXPOSURE For the trial, patients were randomized to either intravenous casirivimab-imdevimab or sotrovimab according to a system therapeutic interchange policy. MAIN OUTCOMES AND MEASURESFor the cohort study, risk ratio (RR) estimates for the primary outcome of hospitalization or death by 28 days were compared between mAb treatment and no mAb treatment using propensity score-matched models. For the comparative effectiveness trial, the primary outcome was hospital-free days (days alive and free of hospitalization) within 28 days after mAb treatment, where patients who died were assigned −1 day in a bayesian cumulative logistic model adjusted for treatment location, age, sex, and time. Inferiority was defined as a 99% posterior probability of an odds ratio (OR) less than 1. Equivalence was defined as a 95% posterior probability that the OR was within a given bound. RESULTSA total of 3069 patients (1023 received mAb treatment: mean [SD] age, 53.2 [16.4] years; 569 women [56%]; 2046 had no mAb treatment: mean [SD] age, 52.8 [19.5] years; 1157 women [57%]) were included in the prospective cohort study, and 3558 patients (mean [SD] age, 54 [18] years; 1919 women [54%]) were included in the randomized comparative effectiveness trial. In propensity score-matched models, mAb treatment was associated with reduced risk of hospitalization or death (RR, 0.40; 95% CI, 0.28-0.57) compared with no treatment. Both (continued)