Real-world experience of monoclonal antibodies in mild-to-moderate COVID-19 patients at a tertiary care center

Vikas Marwah; Robin Choudhary; Sudipt Adhikari; Arpita Pemmaraju; A S Menon; Manish Manrai; Tentu Ajai Kumar; Shipra Verma

doi:10.1016/j.mjafi.2023.03.006

Real-world experience of monoclonal antibodies in mild-to-moderate COVID-19 patients at a tertiary care center

Med J Armed Forces India. 2023 May 18. doi: 10.1016/j.mjafi.2023.03.006. Online ahead of print.

Authors

Vikas Marwah¹, Robin Choudhary², Sudipt Adhikari³, Arpita Pemmaraju⁴, A S Menon⁵, Manish Manrai⁶, Tentu Ajai Kumar⁷, Shipra Verma⁸

Affiliations

¹ Professor & Head (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India.
² Assistant Professor (Pulmonary Medicine, Critical Care & Sleep Medicine), Base Hospital, Delhi Cantt, India.
³ Graded Specialist (Pulmonary Medicine), Chandigarh, India.
⁴ Classified Specialist (Pathology), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India.
⁵ Brig Med, HQ 2 Corps, C/o 56 APO, India.
⁶ Professor, Department of Medicine, Armed Forces Medical College, Pune, India.
⁷ Associate Professor (Pulmonary, Critical Care & Sleep Medicine), Army Institute of Cardiothoracic Sciences (AICTS), Pune, India.
⁸ Graded Specialist (Pathology), Armed Forces Clinic, Delhi, India.

Abstract

Background: Neutralizing antibodies cocktail (casirivimab and imdevimab) has received emergency use authorization recommendation by Food and Drug Administration (FDA) and WHO for mild-to-moderate COVID-19 infection in specific high-risk groups. Antibodies cocktail has shown promising results in preventing progression to severe disease, but the real-world experience is still evolving. Herein, we present a retrospective analysis of 22 patients who were administered the antibodies cocktail between August 2021 and March 2022 at our tertiary care center.

Methods: We conducted an observational retrospective analysis of clinicoradiological, inflammatory parameters, progression of the disease, and outcome among 22 mild and moderate COVID-19 patients treated with antibodies cocktail.

Results: The mean age was 67.7 years (SD ± 18.3) and comprised of 13 males (59%), while 9 were females (40.9%). Nine (40.9%) patients were fully vaccinated with two doses, nine (40.9%) were partially vaccinated with one dose while four patients (18.2%) were unvaccinated, and the rest were unvaccinated. Diabetes and hypertension were the commonest comorbidities; hematological and solid organ malignancies were other comorbidities. Eight patients had radiological opacities consistent with COVID-19 pneumonia and had shown significant regression in four patients after the therapy. None of our patients required supplemental oxygen or progressed to severe acute respiratory distress syndrome. All patients were discharged in a stable condition within 6 days of the therapy.

Conclusions: The neutralizing antibodies cocktail has shown encouraging results in our analysis in preventing progression to severe disease in patients with high-risk conditions.

Keywords: COVID-19; Casirivimab; Imdevimab; Monoclonal antibodies; Neutralizing antibodies.