33 Bamlanivimab Reduces COVID-19-Related Emergency Department Return Visits and Hospitalizations at a Rural US-Mexican Border Hospital

Quenzer, F.; LaFree, A.; Grey, L.; Singh, S.; Smyres, C.; Saikhon, T.; Balog, B.; Wulfovich, S.; Guedez, H. M.; McIntyre, K.; Tomaszewski, C.

Study Objective: To evaluate the effectiveness of bamlanivimab in reducing return emergency department (ED) visits in primarily Latinx/Hispanic patients diagnosed with mild or moderate coronavirus disease 2019 (COVID-19) during a hospital surge. Secondary aims were to evaluate the prevention of subsequent hospitalizations and deaths in a rural, limited-resource hospital near the United States (U.S.)-Mexico border. Methods: We conducted a retrospective, open-label interventional study on 256 adult patients diagnosed with mild-moderate SARS-CoV-2 infection who met the criteria for receiving bamlaninivab from November 1, 2020 to January 17, 2021. The main outcomes of return visits to the ED, hospitalization, and death due to COVID-19 were compared between two groups – those who received bamlanivimab (intervention group) and those who did not receive bamlanivimab (control group). Outcomes were analyzed by using chi-square tests and through a multivariate regression model to adjust for differences in patient demographics, characteristics, and comorbidities. Results: There were 128 patients in the intervention group who received bamlanivimab and 128 patients in the control group who were discharged from the ED. Both of these groups were diagnosed with COVID-19 and discharged. Overall, there was a mean age of 61.7 (+/-13.9) years, mean body mass index (BMI) of 31.0 (+/-6.6) kg/m 2, 91.5% of all patients identified as Latinx/Hispanic, 51.6% of patients were male, and 80.9% of patients reported at least one comorbidity. The most commonly reported comorbidities were coronary artery disease (18.4%), hypertension (59%), and diabetes (41%). After adjusting for chronic kidney disease, the bamlanivimab group demonstrated an 87.5% (OR = 0.283, 95% CI = 0.150, 0.535, p =.0001) reduction in return visits to the ED within 14 days compared to controls. Subsequent hospitalizations were decreased in the bamlanivimab group relative to controls by 96.5% (OR = 0.237, 95% CI = 0.096, 0.584, p =.0017) after adjusting for diabetes. No deaths were observed in the intervention group. Conclusion: Our study shows that targeted bamlanivimab infusions for high-risk COVID-19 patients being discharged from the ED likely reduces return visits to the ED and subsequent hospitalizations and may be an effective strategy for reducing resource utilization in resource-limited, rural, border hospitals.