Real world utilization of REGEN-COV2 at a community hospital

Am J Emerg Med. 2021 Dec:50:129-131. doi: 10.1016/j.ajem.2021.07.050. Epub 2021 Jul 27.

Abstract

Introduction: Monoclonal antibodies received an Emergency Use Authorization (EUA) from the U.S. Food & Drug Administration for the outpatient treatment of mild to moderate coronavirus disease 2019 (COVID-19). REGN-COV2, casirivimab and imdevimab, has been shown to decrease the viral load and healthcare visits of those with mild to moderate COVID-19 who are treated in the outpatient setting.

Objective: To determine 7- and 14-day emergency department (ED) and hospitalization rates of adult patients given REGN-COV2 for the outpatient treatment of COVID-19 at a community hospital.

Methods: A convenience sample of consecutive adult patients given REGN-COV2 from January 18, 2021 through March 31, 2021 for the outpatient treatment of mild to moderate COVID-19. Abstracted data included patient demographics, allergic reactions, ED presentations and hospitalizations at 7 and 14 days, and in-hospital mortality.

Results: A total of 68 patients with a medain age of 69 years (IQR 57-75.5) and 58.3% being female were given REGEN-COV2 during the study period. No allergic reactions were noted during infusion. Of those infused, 18% (12/68) were infused in the ED and had a median length of stay of 477 min. Following infusion, 10% (7/68) of patients re-presented to the ED and 2% (1/68) were hospitalized for COVID-19 at 14 days. In those aged 65 years or greater, 12% (5/42) of patients re-presented to the ED following infusion. Of those who re-presented to the emergency department, the median age was 72.5 years and the median time from infusion to re-presentation was 2.0 days. No patients suffered in-hospital mortality during the study period.

Conclusion: There was a significant length of stay associated with REGN-COV2 infusion in the emergency department. Following REGN-COV2 infusion, few patients under the age of 65 re-presented to the emergency department at seven and 14 days. However, a large number of patients aged over 65 years re-presented to the ED following infusion.

Keywords: COVID-19; Casirivimab; Imdevimab; Monoclonal antibody; REGN-COV2.

MeSH terms

  • Age Factors
  • Aged
  • Ambulatory Care
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antibodies, Neutralizing / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • COVID-19 Drug Treatment*
  • Cohort Studies
  • Drug Combinations
  • Emergency Service, Hospital*
  • Female
  • Hospitalization
  • Hospitals, Community*
  • Humans
  • Male
  • Middle Aged

Substances

  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neutralizing
  • Antiviral Agents
  • Drug Combinations
  • casirivimab and imdevimab drug combination