Real-World Clinical Outcomes of Bamlanivimab and Casirivimab-Imdevimab among High-Risk Patients with Mild to Moderate Coronavirus Disease 2019

Ganesh, Ravindra; Philpot, Lindsey M; Bierle, Dennis M; Anderson, Ryan J; Arndt, Lori L; Arndt, Richard F; Culbertson, Tracy L; Destro Borgen, Molly J; Hanson, Sara N; Kennedy, Brian D; Kottke, Brian B; Larsen, Jennifer J; Ramar, Priya; Rosedahl, Jordan K; Seville, Maria Teresa; Speicher, Leigh L; Tulledge-Scheitel, Sidna M; Wilker, Caroline G; Razonable, Raymund R

BACKGROUND: Bamlanivimab and casirivimab-imdevimab are authorized for treatment of high-risk patients with mild to moderate coronavirus disease-2019 (COVID-19). We compared the outcomes of patients who received these therapies to identify factors associated with hospitalization and other clinical outcomes. METHODS: Adult patients who received monoclonal antibody from November 19, 2020 to February 11, 2021 were selected and divided into those who received bamlanivimab (n=2747) and casirivimab-imdevimab (n=849). The 28-day all-cause and COVID-19-related hospitalizations were compared between the groups. RESULTS: The population included 3596 patients; median age was 62 years; and 50% were female. All had ≥1 medical comorbidity; 55% had multiple comorbidities. All cause- and COVID-19-related hospitalization rates at 28 days were 3.98% and 2.56%, respectively. After adjusting for medical comorbidities, there was no significant difference in all cause- and COVID-19-related hospitalization rates between bamlanivimab and casirivimab-imdevimab (adjusted HR, 1.4, 95% CI 0.9-2.2 and 1.6, 95% CI 0.8-2.7, respectively). Chronic kidney, respiratory and cardiovascular diseases, and immunocompromised status were associated with higher likelihood of hospitalization. CONCLUSION: This observational study on the use of bamlanivimab and casirivimab-imdevimab in high-risk patients showed similarly low rates of hospitalization. The number and type of medical comorbidities are associated with hospitalizations after monoclonal antibody treatment.