Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

doi:10.1007/s15010-021-01657-y

. 2021 Dec;49(6):1313-1318.

doi: 10.1007/s15010-021-01657-y. Epub 2021 Jul 9.

Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Affiliations

¹ Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
² School of Medicine, Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany.
³ Department of Traumatology, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁴ Department of Neurosurgery, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁵ School of Medicine, Hospital Pharmacy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁶ School of Medicine, Institute of Virology, Technical University of Munich, Munich, Germany.
⁷ Institute of Medical Statistics and Epidemiology, Technical University of Munich, Munich, Germany.
⁸ Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany. roman.iakoubov@mri.tum.de.

PMID: 34244967
PMCID: PMC8269399
DOI: 10.1007/s15010-021-01657-y

Free PMC article

Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Johanna Koehler et al. Infection. 2021 Dec.

Free PMC article

. 2021 Dec;49(6):1313-1318.

doi: 10.1007/s15010-021-01657-y. Epub 2021 Jul 9.

Affiliations

¹ Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
² School of Medicine, Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany.
³ Department of Traumatology, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁴ Department of Neurosurgery, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁵ School of Medicine, Hospital Pharmacy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
⁶ School of Medicine, Institute of Virology, Technical University of Munich, Munich, Germany.
⁷ Institute of Medical Statistics and Epidemiology, Technical University of Munich, Munich, Germany.
⁸ Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany. roman.iakoubov@mri.tum.de.

PMID: 34244967
PMCID: PMC8269399
DOI: 10.1007/s15010-021-01657-y

Abstract

Additional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

Keywords: Bamlanivimab; COVID-19; Casirivimab; Imdevimab; Monoclonal spike antibodies; SARS-CoV2.

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Conflict of interest statement

Dr. Spinner received consultancy fees, speaker’s honoraria, and/or reimbursement of travel expenses from Gilead Sciences, Eli Lilly, Janssen-Cilag, MSD and received consultancy fees from Molecular Partners and Formycon in the context of COVID-19. He also received research support indirectly from Apeiron, Eli Lilly, Gilead Sciences, and Janssen-Cilag. Outside this context, he received consultancy fees, speaker’s honoraria, and reimbursement of travel expenses from AbbVie, Gilead Sciences, Janssen-Cilag, MSD, and ViiV Healthcare/GSK, as well as research support (indirectly to his employer) from Gilead Sciences, GSK, Jansen-Cilag, MSD, and ViiV Healthcare. All other authors report no relevant conflict of interest.

Figures

**Fig. 1**
Survival analysis by Kaplan–Meier curve and log-rank (Mantel–Cox) test. A Significantly less patients in the mABs group require dexamethasone or remdesivir treatment due to decreased pulmonary function (8 vs. 0 cases, p = 0.036). B While indicating an improved survival of patients treated with monoclonal antibodies, the analysis does not reach significance due to small number of patients (6 vs. 0 cases, p = 0.068)

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References

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1. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, Hohmann E, Chu HY, Luetkemeyer A, Kline S, et al. Remdesivir for the treatment of Covid-19—final report. N Engl J Med. 2020;383:1813–1826. doi: 10.1056/NEJMoa2007764. - DOI - PMC - PubMed
1. Chen P, Nirula A, Heller B, Gottlieb RL, Boscia J, Morris J, Huhn G, Cardona J, Mocherla B, Stosor V, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med. 2021;384:229–237. doi: 10.1056/NEJMoa2029849. - DOI - PMC - PubMed
1. ACTIV-3/TICO LY-CoV555 Study Group. Lundgren JD, Grund B, Barkauskas CE, Holland TL, Gottlieb RL, Sandkovsky U, Brown SM, Knowlton KU, Self WH, et al. A neutralizing monoclonal antibody for hospitalized patients with Covid-19. N Engl J Med. 2021;384:905–914. doi: 10.1056/NEJMoa2033130. - DOI - PMC - PubMed
1. Starr TN, Greaney AJ, Addetia A, Hannon WW, Choudhary MC, Dingens AS, Li JZ, Bloom JD. Prospective mapping of viral mutations that escape antibodies used to treat COVID-19. Science. 2021;371:850–854. doi: 10.1126/science.abf9302. - DOI - PMC - PubMed

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[1] RECOVERY Collaborative Group. Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384:693–704. doi: 10.1056/NEJMoa2021436. - DOI - PMC - PubMed

[2] RECOVERY Collaborative Group. Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384:693–704. doi: 10.1056/NEJMoa2021436. - DOI - PMC - PubMed

[3] Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, Hohmann E, Chu HY, Luetkemeyer A, Kline S, et al. Remdesivir for the treatment of Covid-19—final report. N Engl J Med. 2020;383:1813–1826. doi: 10.1056/NEJMoa2007764. - DOI - PMC - PubMed

[4] Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, Hohmann E, Chu HY, Luetkemeyer A, Kline S, et al. Remdesivir for the treatment of Covid-19—final report. N Engl J Med. 2020;383:1813–1826. doi: 10.1056/NEJMoa2007764. - DOI - PMC - PubMed

[5] Chen P, Nirula A, Heller B, Gottlieb RL, Boscia J, Morris J, Huhn G, Cardona J, Mocherla B, Stosor V, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med. 2021;384:229–237. doi: 10.1056/NEJMoa2029849. - DOI - PMC - PubMed

[6] Chen P, Nirula A, Heller B, Gottlieb RL, Boscia J, Morris J, Huhn G, Cardona J, Mocherla B, Stosor V, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med. 2021;384:229–237. doi: 10.1056/NEJMoa2029849. - DOI - PMC - PubMed

[7] ACTIV-3/TICO LY-CoV555 Study Group. Lundgren JD, Grund B, Barkauskas CE, Holland TL, Gottlieb RL, Sandkovsky U, Brown SM, Knowlton KU, Self WH, et al. A neutralizing monoclonal antibody for hospitalized patients with Covid-19. N Engl J Med. 2021;384:905–914. doi: 10.1056/NEJMoa2033130. - DOI - PMC - PubMed

[8] ACTIV-3/TICO LY-CoV555 Study Group. Lundgren JD, Grund B, Barkauskas CE, Holland TL, Gottlieb RL, Sandkovsky U, Brown SM, Knowlton KU, Self WH, et al. A neutralizing monoclonal antibody for hospitalized patients with Covid-19. N Engl J Med. 2021;384:905–914. doi: 10.1056/NEJMoa2033130. - DOI - PMC - PubMed

[9] Starr TN, Greaney AJ, Addetia A, Hannon WW, Choudhary MC, Dingens AS, Li JZ, Bloom JD. Prospective mapping of viral mutations that escape antibodies used to treat COVID-19. Science. 2021;371:850–854. doi: 10.1126/science.abf9302. - DOI - PMC - PubMed

[10] Starr TN, Greaney AJ, Addetia A, Hannon WW, Choudhary MC, Dingens AS, Li JZ, Bloom JD. Prospective mapping of viral mutations that escape antibodies used to treat COVID-19. Science. 2021;371:850–854. doi: 10.1126/science.abf9302. - DOI - PMC - PubMed

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Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Affiliations

Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

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