2022-11-29·Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Predictors of COVID-19 hospitalization after sotrovimab in hematologic malignancy patients during the BA.1 Omicron surge.
作者: Judy Yan ; Samantha N Steiger ; Rich Kodama ; Jerome Fender ; Carrie Tan ; Justin Laracy ; Nina Cohen ; Tracy McMillen ; Krupa Jani ; Elizabeth V Robilotti ; N Esther Babady ; Susan K Seo ; Mini Kamboj
Sotrovimab is an anti-spike neutralization monoclonal antibody (mAB) developed to reduce the risk of Coronavirus Disease 2019 (COVID-19) progression and advancement to hospitalization in high-risk patients. Currently, there is limited research describing the association of sotrovimab treatment in patients with hematologic malignancies (HM) and the predictive factors of hospitalization.
We performed an observational study of 156 consecutive cancer patients who received sotrovimab at Memorial Sloan Kettering Cancer Center in New York City during the BA.1 Omicron surge. We evaluated the demographic, clinical, and laboratory characteristics of the patients who had subsequent COVID-19-related hospitalization(s) compared to those who did not.
Among the 156 study patients, seventeen (17, 11%) were hospitalized of which four were readmitted for COVID-19-related complications; three deaths were attributed to COVID-19. Results from multivariable logistic regression show significant factors associated with hospitalization include patients on anti-CD20 therapy (adjusted OR = 5.59, 95% CI (1.73 - 18.12), p = 0.004) and with relapse/refractory disease (adjusted OR = 5.69, 95% CI (1.69 - 19.16), p = 0.005). Additionally, whole-genome sequencing of SARS-CoV-2 detected high occurrences of mutations in the spike gene associated with treatment-related resistance longitudinal samples from 11 patients treated with sotrovimab.
While sotrovimab is effective at reducing COVID-19 hospitalization and disease severity in HM patients when administered early, patients who received anti-CD20 antibodies showed substantial morbidity. Due to the high potential for resistance mutation to sotrovimab and increased morbidity in patients on anti-CD20 therapy, combination treatment should be explored to determine whether it provides added benefits compared to monotherapy.
2022-03-01·Infection & chemotherapy
Effectiveness of Regdanvimab at Preventing the Need for Oxygen Therapy in Patients with Mild-to-Moderate COVID-19: A Retrospective Cohort Study.
作者: Seong Jin Choi ; Sang-Won Park ; Eunyoung Lee
Monoclonal antibodies are a treatment option for patients with mild-to-moderate coronavirus disease (COVID-19). We investigated the effectiveness of regdanvimab, an anti-severe acute respiratory syndrome coronavirus-2 monoclonal antibody approved in Korea, in the treatment of patients with mild-to-moderate COVID-19.
MATERIALS AND METHODS:
Medical records of patients who were admitted to a COVID-19 designated hospital during the study period of February 1 to June 31 and met the indications for administration of regdanvimab were reviewed to assess baseline characteristics and clinical outcomes such as supplemental oxygen requirements, mortality, and length of hospitalization. Multivariable logistic regression analysis was conducted to identify factors associated with requiring supplemental oxygen. Subgroup analysis was performed according to the presence of pneumonia confirmed on a chest X-ray.
Three hundred ninety-eight COVID-19 patients were included in the study, and 65 (16.3%) of them were administered regdanvimab. The proportion of patients requiring supplemental oxygen was significantly lower in the regdanvimab group than in the control group (6.2% vs. 20.1%, P = 0.007). There was no significant difference in mortality (0% vs. 1.5%, P >0.999) and the length of hospitalization (median: 10 days vs. 10 days, P = 0.267) between two groups. The multivariable analysis demonstrated that administration of regdanvimab was independently associated with lower oxygen supplement [odds ratio (OR): 0.20, 95% confidence interval (CI): 0.06 - 0.55, P = 0.004] after adjustment of potential risk factors related to supplemental oxygen including age, sex, chest X-ray abnormality, and underlying chronic kidney disease. Among the patients with pneumonia radiologically, administration of regdanvimab was also associated with lower risk of oxygen supplement (OR: 0.13, 95% CI: 0.02 - 0.46, P = 0.007).
Regdanvimab use was related to lower need for supplemental oxygen in patients with mild-to-moderate COVID-19 for the indications for administration of regdanvimab.
2021-08-01·Open forum infectious diseases3区 · 医学
Post-severe Acute Respiratory Syndrome Coronavirus 2 Monoclonal Antibody Treatment Hospitalizations as a Sentinel for Emergence of Viral Variants in New York City.
3区 · 医学
作者: Kelsie Cowman ; Yi Guo ; Liise-Anne Pirofski ; David Wong ; Hongkai Bao ; Victor Chen ; Una Hopkins ; Erin Andrews ; Joseph Hamel ; Marla Keller ; Eran Bellin ; Raja Thota ; Patricia Davis ; Edwin Torres Rodriguez ; Pooja Suthar ; Lauren Allen ; James Rossi ; Adam Haviland ; Erika Orner ; Wendy Szymczak ; Sadahf Shujauddin ; James McCarthy ; Barbara Binder ; Vanitha Pushparaj ; Linda Bard ; Vincent Frank Pierino ; Leslie Alsina ; David Esses ; Alicia McCaskie ; Caron Campbell ; Tabitha Madzura ; Andrew Wollowitz ; Kelly Basset ; Deborah White ; Rafael Ruiz ; Frank Sosnowski ; Priya Nori
We partnered with the US Department of Health and Human Services to treat high-risk, nonadmitted coronavirus disease 2019 (COVID-19) patients with bamlanivimab in the Bronx, New York per Emergency Use Authorization criteria. Increasing posttreatment hospitalizations were observed monthly between December 2020 and March 2021 in parallel to the emergence of severe acute respiratory syndrome coronavirus 2 variants in New York City.