Retrospective Analysis of Vaccinated and Unvaccinated COVID-19 Patients Treated with Monoclonal Antibodies (mAb) and Their Emergent Needs (RAVEN)

Abstract

Strategies to combat COVID-19 include vaccines and Monoclonal Antibody Therapy. While vaccines aim to prevent development of symptoms, Monoclonal Antibody Therapy aims to prevent the progression of mild to severe disease. An increasing number of COVID-19 infections in vaccinated patients raised the question of whether vaccinated and unvaccinated COVID-19 positive patients respond differently to Monoclonal Antibody Therapy. The answer can help prioritize patients if resources are scarce. We performed a retrospective study to evaluate and compare the outcomes and risks for disease progression between vaccinated and unvaccinated COVID-19 patients treated with Monoclonal Antibody Therapy by measuring the number of Emergency Department visits and hospitalizations within 14 days as well as the progression to severe disease, defined through the Intensive Care Unit admissions within 14 days, and death within 28 days from the Monoclonal Antibody infusion. From 3898 included patients, 2009 (51.5%) were unvaccinated at the time of Monoclonal Antibody infusion. Unvaccinated patients had more Emergency Department visits (217 vs. 79, p < 0.0001), hospitalizations (116 vs. 38, p < 0.0001), and progression to severe disease (25 vs. 19, p = 0.016) following treatment with Monoclonal Antibody Therapy. After adjustment for demographics and comorbidities, unvaccinated patients were 2.45 times more likely to seek help in the Emergency Department and 2.70 times more likely to be hospitalized. Our data suggest the added benefit between the COVID-19 vaccine and Monoclonal Antibody Therapy.

Decoding the historical tale: COVID-19 impact on haematological malignancy patients—EPICOVIDEHA insights from 2020 to 2022

“…The study revealed that among unvaccinated patients, those who received monoclonal antibodies alone or in combination with antiviral medications had the highest likelihood of survival, aligning with findings from studies conducted on the general population. 39 This underscores the importance of tailoring treatment options based on vaccination status and the severity of illness of each patient.…”

A Descriptive, Retrospective Analysis of COVID-19 Passive Antibody Therapy and Its Effects on Morbidity and Mortality in Patients Receiving B-Cell-Depleting Therapies

“…Studies have shown that vaccination against SARS-CoV-2 in patients with hematologic malignancies was less effective in producing of neutralizing antibodies compared to controls without a hematologic malignancy and active treatment with B-cell-depleting agents further hindered antibody response to vaccination [5]. Some studies suggested additive benefits between COVID-19 vaccination and administration of monoclonal antibodies [27,28]. The fact that 80% of our outpatient cohort was vaccinated may support the presence of such a benefit of COVID-19 monoclonal antibodies to vaccination.…”