Abstract
Introduction: The impact of vaccination and casirivimab-imdevimab monoclonal antibody treatment on the clinical outcome of COVID-19 during a period of SARS-CoV-2 Delta surge is not known.Aim and Methods: All patients with COVID-19 at our facilities in the US Midwest were enrolled to assess breakthrough cases among vaccinated individuals and to compare the rates of hospitalization between casirivimab-imdevimab treated versus untreated patients. The study period occurred in July 2021 during a period dominated by the Delta variant.Results: The majority (68.1%) of 630 COVID-19 cases occurred in unvaccinated individuals. Among 403 patients eligible for monoclonal antibody treatment, the 28-day hospitalization rate was 2.6% of 112 patients who received treatment with casirivimab-imdevimab, compared to 16.6% of 291 eligible high-risk patients who did not receive casirivimab-imdevimab (Odds Ratio [OR]: 0.138, 95% confidence interval (CI): 0.0426–0.4477, p = 0.001). Casirivimab-imdevimab treatment was associated with lower rates of hospitalization among the vaccinated and unvaccinated cohorts.Conclusions: During a SARS-CoV-2 Delta surge, breakthrough COVID-19 occurred among vaccinated persons, especially among those with multiple medical comorbidities. Casirivimab-imdevimab treatment was associated with significantly lower rates of hospitalization in vaccinated and unvaccinated persons.
Highlights
IntroductionThe United States is experiencing a surge of coronavirus disease2019 (COVID-19) attributed to Severe Acute Respiratory Syndromecoronavirus 2 (SARS-CoV-2) lineage B.1.617.2 (Delta)
The impact of vaccination and casirivimab-imdevimab monoclonal antibody treatment on the clinical outcome of COVID-19 during a period of SARS-CoV-2 Delta surge is not known
COVID-19 vaccination is highly recommended as the primary strat egy to reduce SARS-CoV-2 Delta outbreaks and its great burden to healthcare systems
Summary
The United States is experiencing a surge of coronavirus disease2019 (COVID-19) attributed to Severe Acute Respiratory Syndromecoronavirus 2 (SARS-CoV-2) lineage B.1.617.2 (Delta). We have previously observed a 70% relative risk reduction in hospital admission among patients who received the monoclonal antibody combination of casirivimab-imdevimab compared to a propensity-matched untreated cohort with mild to moderate COVID-19 in December 2020 to April 2021 – a period prior to the Delta surge in US [8]. Whether persons who have been vaccinated against COVID-19 benefit from monoclonal antibody if they develop breakthrough COVID-19 is not known. In this communi cation, we assessed the outcomes of 630 patients with COVID-19 during the early period of the Delta surge in our community. We assessed the impact of vaccination and casirivimab-imdevimab treatment
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