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.

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.…”