SARS-CoV-2 neutralizing antibodies for COVID-19: Outcomes for bamlanivimab versus bamlanivimab-etesevimab combination in a racially diverse cohort of patients with significant comorbidities.

Abstract

What Is Known and ObjectiveAnti‐spike monoclonal antibodies (MAB) including bamlanivimab (BAM) and bamlanivimab/etesevimab (BAM/E) have shown reduced hospitalization rates for non‐severe coronavirus disease 2019 (COVID‐19) in clinical trials. Recent data have provided real‐world hospitalization rates for high‐risk patients treated with BAM, however, data on a similar cohort treated with BAM/E are lacking.MethodsThis retrospective cohort study evaluated outpatients ≥18 years with laboratory‐confirmed mild/moderate COVID‐19 who received MAB from 1 December 2020 to 19 April 2021. Use of BAM monotherapy changed to BAM/E combination on 27 March 2021. Primary outcome was overall rate of COVID‐19 related‐hospitalization, including comparison of hospitalization rates between MAB‐formulation groups. Secondary outcomes were 30‐day mortality and length of stay (LOS).Results and DiscussionThe population included 643 patients (BAM and BAM/E); median age was 58 years, 43% were male, median BMI was 33 kg/m2, and 24% self‐identified as Black. Patients in the BAM/E combination group were significantly younger with higher median BMI and a longer time from symptom onset to infusion. The incidence of 30‐day COVID‐19 related hospitalization was similar between patients receiving either BAM or BAM/E combination (7.8% and 7.2%, respectively).What Is New and ConclusionThis study represents the first such publication of real‐world BAM/E hospitalization outcomes. Hospitalization rates utilizing BAM/E were comparable to BAM in our real‐world study.