Vaccinated patients have reduced rates of hospitalization after receiving casirivimab and imdevimab for COVID-19

Zitek, Tony; Jodoin, Kathleen; Kheradia, Tarang; Napolillo, Ryan; Dalley, Michael; Quenzer, Faith; Farcy, David A.

doi:10.1016/j.ajem.2021.10.044

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…In a single-center study of 1222 patients, Zitek et al found that vaccination status significantly decreased the odds of hospitalization within 28 days of mAb infusion but not the odds of ED presentation. This study had an uneven distribution of vaccinated and unvaccinated patients (16.2% vs. 79.3%, respectively), and did not evaluate risk factors distribution in the groups [ 20 ]. Bierle et al noted decreased frequency of hospitalization in both vaccinated and unvaccinated patients following mAb treatment compared with untreated controls.…”

Section: Discussionmentioning

confidence: 99%

“…While vaccination and mAb are independently associated with reduced hospitalization and all-cause mortality in COVID-19 positive patients, and mAb therapy further decreases the risk of disease progression in vaccinated patients [ 18 , 19 , 20 ], data comparing clinical outcomes in vaccinated and unvaccinated patients treated with mAb is unclear. Studies examining mAb treatment outcomes regarding vaccination status had conflicting results [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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“…We also performed multivariate logistic regression analyses to compare return visit and hospitalization rates for the three groups. Age, sex, BMI, and vaccination status were chosen as predictor variables for the model based on consistency of documentation and prior studies demonstrating associations of these variables with worse outcomes from COVID-19 16,18–20 . Duration of symptoms also was chosen as a predictor variable (continuous variable) because earlier administration of casirivimab/imdevimab may be associated with better outcomes 21 .…”

Section: Methodsmentioning

confidence: 99%

“…This was a secondary analysis using data from a recently published study assessing the benefits of vaccination against COVID-19 in patients receiving casirivimab/imdevimab. 16 Both the original study and this study were retrospective cohort analyses. During the original study, we noticed substantial differences in baseline characteristics and outcomes in people of different races/ethnicities.…”

Section: Methodsmentioning

confidence: 99%

“…Age, sex, BMI, and vaccination status were chosen as predictor variables for the model based on consistency of documentation and prior studies demonstrating associations of these variables with worse outcomes from COVID-19. 16,[18][19][20] Duration of symptoms also was chosen as a predictor variable (continuous variable) because earlier administration of casirivimab/imdevimab may be associated with better outcomes. 21 In the multivariate models, the assumption of linearity in the logit was checked for age, BMI, and duration of symptoms using the Box-Tidwell test.…”

Section: Methodsmentioning

confidence: 99%

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Discrepancies in Outcomes by Race and Ethnicity in COVID-19 Patients Receiving Casirivimab and Imdevimab

Zitek¹,

Bui²,

Eily³

et al. 2023

Southern Medical Journal

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Objectives: The Centers for Disease Control and Prevention has reported increased rates of coronavirus disease 2019 (COVID-19)-related hospitalizations and deaths in Black and Hispanic individuals. One contributing factor to this may be a difference in access to treatment. We thus sought to compare the outcomes of Black, non-Hispanic patients and Hispanic patients with White, non-Hispanic individuals using a group of patients with COVID-19 who received casirivimab/imdevimab.Methods: This was a secondary analysis of data from a previously published retrospective chart review of patients who received casirivimab/ imdevimab for COVID-19 between December 9, 2020 and August 20, 2021, when they were treated at one of three facilities within a single hospital system. We compared the baseline characteristics (including age, sex, body mass index, duration of symptoms, and vaccination status) and outcomes of Black, non-Hispanic patients and Hispanic patients with those of White, non-Hispanic patients. Our primary outcome was the odds of a return visit to the emergency department (ED) within 28 days of treatment as assessed by multivariate logistic regression. We also assessed the rates of return visits to the ED for symptoms caused by COVID-19, hospitalizations, and hospitalizations from hypoxia.Results: In total, 1318 patients received casirivimab/imdevimab for COVID-19 at the three study facilities. Of these, 410 (31.1%) identified themselves as White and non-Hispanic, 88 (6.7%) as Black and non-Hispanic, and 736 (55.8%) as Hispanic. Vaccination rates at the time of treatment were as follows: Black, non-Hispanic 10.2%, Hispanic 13.6%, and White, non-Hispanic 21.5%. On multivariate analysis, the odds of return visits to the ED within 28 days were higher for Black, non-Hispanic patients and Hispanic patients as compared with White, non-Hispanic patients, with odds ratios of 2.8 (95% confidence interval [CI] 1.4-5.5, P = 0.003) and of 2.3 (95% CI 1.5-3.6, P = 0.0002), respectively. For hospitalizations caused by hypoxia within 28 days of treatment, the adjusted odds ratio for Black, non-Hispanic patients was 3.4 (95% CI 1.1-10.5, P = 0.03) as compared with White, non-Hispanic patients. There were no other statistically significant differences among groups in regard to subsequent hospitalizations within 28 days.Conclusions: Black, non-Hispanic patients and Hispanic patients are more likely to make a return visit to the ED within 28 days after casirivimab/imdevimab treatment for COVID-19 as compared with White, non-Hispanic patients. This holds true even when adjusting for higher vaccination rates among White, non-Hispanic individuals.

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Impact of a subcutaneous casirivimab and imdevimab clinic in outpatients with symptomatic COVID-19: A single-center, propensity-matched cohort study

Rhudy

Bochenek

Thomas

et al. 2022

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To evaluate the success of a clinic for subcutaneous administration of casirivmab and imdevimab (REGEN-COV; Regeneron) for treatment of patients with symptomatic mild to moderate coronavirus disease 2019 (COVID-19) in terms of preventing disease progression and healthcare utilization. Methods This retrospective single-center, propensity-matched cohort study examined healthcare utilization outcomes for patients who received subcutaneous casirivimab and imdevimab at a pharmacist-led clinic of an academic health system. Eligible patients were treated between August 1, 2021, and January 5, 2022, and were at high risk for COVID-19 disease progression. Treatment patients were propensity matched with high-risk control patients with a diagnosis of COVID-19 in the same timeframe who did not receive casirivimab and imdevimab. Patients were followed for 30 days for collection of data on inpatient admissions, emergency department visits, and mortality. Risk of a 30-day healthcare utilization event was assessed and tested for statistical significance utilizing McNemar’s test. Results A total of 585 patients who received treatment with subcutaneous casirivimab and imdevimab were matched with 585 patients who did not receive casirivimab and imdevimab therapy. Patients who received casirivimab and imdevimab had significantly lower risk of a 30-day all-cause inpatient admission event than untreated patients (relative risk reduction, 61.2%; P < 0.0001). Treated patients also had a significantly lower risk of 30-day all-cause emergency department visit than untreated subjects (relative risk reduction, 36.6%; P = 0.0021). There were 6 mortality events in the untreated group and no mortality events in the treatment group. Conclusion This study provides evidence for the effectiveness of a subcutaneous casirivimab and imdevimab clinic in preventing progression of symptomatic mild to moderate COVID-19.

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Vaccinated patients have reduced rates of hospitalization after receiving casirivimab and imdevimab for COVID-19

Cited by 6 publications

References 9 publications

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

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

Discrepancies in Outcomes by Race and Ethnicity in COVID-19 Patients Receiving Casirivimab and Imdevimab

Impact of a subcutaneous casirivimab and imdevimab clinic in outpatients with symptomatic COVID-19: A single-center, propensity-matched cohort study

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