Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients
Abstract Background Neutralizing monoclonal antibodies (mAbs) are highly effective in reducing hospitalization and mortality among early symptomatic COVID-19 patients in clinical trials and real-world data. While resistance to some mAbs has since emerged among new variants, characteristics associate...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07819-z |
| _version_ | 1798019090685624320 |
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| author | David J. Douin Adane F. Wogu Laurel E. Beaty Nichole E. Carlson Tellen D. Bennett Neil R. Aggarwal David A. Mayer Toan C. Ong Seth Russell Jeffrey Steele Jennifer L. Peers Kyle C. Molina Matthew K. Wynia Adit A. Ginde |
| author_facet | David J. Douin Adane F. Wogu Laurel E. Beaty Nichole E. Carlson Tellen D. Bennett Neil R. Aggarwal David A. Mayer Toan C. Ong Seth Russell Jeffrey Steele Jennifer L. Peers Kyle C. Molina Matthew K. Wynia Adit A. Ginde |
| author_sort | David J. Douin |
| collection | DOAJ |
| description | Abstract Background Neutralizing monoclonal antibodies (mAbs) are highly effective in reducing hospitalization and mortality among early symptomatic COVID-19 patients in clinical trials and real-world data. While resistance to some mAbs has since emerged among new variants, characteristics associated with treatment failure of mAbs remain unknown. Methods This multicenter, observational cohort study included patients with COVID-19 who received mAb treatment between November 20, 2020, and December 9, 2021. We utilized electronic health records from a statewide health system plus state-level vaccine and mortality data. The primary outcome was mAb treatment failure, defined as hospitalization or death within 28 days of a positive SARS-CoV-2 test. Results COVID-19 mAb was administered to 7406 patients. Hospitalization within 28 days of positive SARS-CoV-2 test occurred in 258 (3.5%) of all patients who received mAb treatment. Ten patients (0.1%) died within 28 days, and all but one were hospitalized prior to death. Characteristics associated with treatment failure included having two or more comorbidities excluding obesity and immunocompromised status (adjusted odds ratio [OR] 3.71, 95% confidence interval [CI] 2.52–5.56), lack of SARS-CoV-2 vaccination (OR 2.73, 95% CI 2.01–3.77), non-Hispanic black race/ethnicity (OR 2.21, 95% CI 1.20–3.82), obesity (OR 1.79, 95% CI 1.36–2.34), one comorbidity (OR 1.68, 95% CI 1.11–2.57), age ≥ 65 years (OR 1.62, 95% CI 1.13–2.35), and male sex (OR 1.56, 95% CI 1.21–2.02). Immunocompromised status (none, mild, or moderate/severe), pandemic phase, and type of mAb received were not associated with treatment failure (all p > 0.05). Conclusions Comorbidities, lack of prior SARS-CoV-2 vaccination, non-Hispanic black race/ethnicity, obesity, age ≥ 65 years, and male sex are associated with treatment failure of mAbs. |
| first_indexed | 2024-04-11T16:34:54Z |
| format | Article |
| id | doaj.art-9243363dc9f34305a5f57b6c977b0775 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-11T16:34:54Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-9243363dc9f34305a5f57b6c977b07752022-12-22T04:13:52ZengBMCBMC Infectious Diseases1471-23342022-11-0122111010.1186/s12879-022-07819-zAssociation between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatientsDavid J. Douin0Adane F. Wogu1Laurel E. Beaty2Nichole E. Carlson3Tellen D. Bennett4Neil R. Aggarwal5David A. Mayer6Toan C. Ong7Seth Russell8Jeffrey Steele9Jennifer L. Peers10Kyle C. Molina11Matthew K. Wynia12Adit A. Ginde13Department of Anesthesiology, University of Colorado School of MedicineDepartment of Biostatistics and Informatics, Colorado School of Public HealthDepartment of Biostatistics and Informatics, Colorado School of Public HealthDepartment of Biostatistics and Informatics, Colorado School of Public HealthColorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical CampusDepartment of Medicine, University of Colorado School of MedicineDepartment of Biostatistics and Informatics, Colorado School of Public HealthDepartment of Medicine, University of Colorado School of MedicineSection of Informatics and Data Science, Department of Pediatrics, University of Colorado School of MedicineResearch Informatics, Children’s Hospital ColoradoDepartment of Emergency Medicine, University of Colorado School of MedicineDivision of Infectious Diseases, University of Colorado School of MedicineSection of General Internal Medicine, Department of Medicine, University of Colorado School of MedicineColorado Clinical and Translational Sciences Institute, University of Colorado Anschutz Medical CampusAbstract Background Neutralizing monoclonal antibodies (mAbs) are highly effective in reducing hospitalization and mortality among early symptomatic COVID-19 patients in clinical trials and real-world data. While resistance to some mAbs has since emerged among new variants, characteristics associated with treatment failure of mAbs remain unknown. Methods This multicenter, observational cohort study included patients with COVID-19 who received mAb treatment between November 20, 2020, and December 9, 2021. We utilized electronic health records from a statewide health system plus state-level vaccine and mortality data. The primary outcome was mAb treatment failure, defined as hospitalization or death within 28 days of a positive SARS-CoV-2 test. Results COVID-19 mAb was administered to 7406 patients. Hospitalization within 28 days of positive SARS-CoV-2 test occurred in 258 (3.5%) of all patients who received mAb treatment. Ten patients (0.1%) died within 28 days, and all but one were hospitalized prior to death. Characteristics associated with treatment failure included having two or more comorbidities excluding obesity and immunocompromised status (adjusted odds ratio [OR] 3.71, 95% confidence interval [CI] 2.52–5.56), lack of SARS-CoV-2 vaccination (OR 2.73, 95% CI 2.01–3.77), non-Hispanic black race/ethnicity (OR 2.21, 95% CI 1.20–3.82), obesity (OR 1.79, 95% CI 1.36–2.34), one comorbidity (OR 1.68, 95% CI 1.11–2.57), age ≥ 65 years (OR 1.62, 95% CI 1.13–2.35), and male sex (OR 1.56, 95% CI 1.21–2.02). Immunocompromised status (none, mild, or moderate/severe), pandemic phase, and type of mAb received were not associated with treatment failure (all p > 0.05). Conclusions Comorbidities, lack of prior SARS-CoV-2 vaccination, non-Hispanic black race/ethnicity, obesity, age ≥ 65 years, and male sex are associated with treatment failure of mAbs.https://doi.org/10.1186/s12879-022-07819-zCOVID-19SARS-CoV-2Monoclonal antibodies |
| spellingShingle | David J. Douin Adane F. Wogu Laurel E. Beaty Nichole E. Carlson Tellen D. Bennett Neil R. Aggarwal David A. Mayer Toan C. Ong Seth Russell Jeffrey Steele Jennifer L. Peers Kyle C. Molina Matthew K. Wynia Adit A. Ginde Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients BMC Infectious Diseases COVID-19 SARS-CoV-2 Monoclonal antibodies |
| title | Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients |
| title_full | Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients |
| title_fullStr | Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients |
| title_full_unstemmed | Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients |
| title_short | Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients |
| title_sort | association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for covid 19 outpatients |
| topic | COVID-19 SARS-CoV-2 Monoclonal antibodies |
| url | https://doi.org/10.1186/s12879-022-07819-z |
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