COVID-19 is a contagious disease that poses a risk of overburdening the health care system due to its large scale. Monoclonal antibodies (mAb) against SARS-CoV-2 help to ease the burden of COVID-19 on the patient and the healthcare system, as they prevent infection or progression to a severe disease and related complications. This is especially important for patients with risk factors for the development of more severe symptoms and, as a result, hospitalization.
The purpose of this research was to analyze the characteristics of patients who received mAb against SARS-CoV-2 at Murska Sobota General Hospital, and to determine what the outcomes of mAb use were in terms of preventing infection or hospitalization and death. We performed a retrospective survey, including 232 mAb order forms. We reviewed the patient's medical history and discharge letter when the patient received the mAb and other patient's treatments at that hospital within 6 months of administration.
For all mAb, the most frequent comorbidities were arterial hypertension, cancer and atrial fibrillation. The most frequently prescribed drugs in regular therapy were pantoprazole, bisoprolol, acetylsalicylic acid, furosemide and statins. Most patients did not have a history of COVID-19, except in the case of tixagevimab/cilgavimab. The highest proportion of unvaccinated patients was among patients who received regdanvimab (50% of unvaccinated patients) and the lowest among those who received tixagevimab/cilgavimab (11% of unvaccinated patients). Casirivimab/imdevimab was the most successful mAb at prophylaxis (no patient contracted COVID-19). Tixagevimab/cilgavimab was the most effective mAb in preventing hospitalization due to COVID-19 (96% efficacy), while sotrovimab was the least effective (88% efficacy). 28-day survival was the highest with tixagevimab/cilgavimab and the lowest with regdanvimab. 6-month survival was the highest with casirivimab/imdevimab and the lowest with sotrovimab and regdanvimab. We found that with regdanvimab, the risk of death increases with male gender and more comorbidities (impact on 28-day survival), with casirivimab/imdevimab, the risk of death increases with female gender, older age, a greater number of prescribed drugs and a longer period of time since the last vaccination (impact on 6 -month survival), and in the case of tisagevimab/cilgavimab, the risk of death increases with older age, infection as the cause of the mAb administration and lack of history of COVID-19 (impact on 6-month survival).
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