Monoclonal Antibody Treatment of Breakthrough COVID-19 in Fully Vaccinated Individuals with High-Risk Comorbidities

被引:38
作者
Bierle, Dennis M. [1 ]
Ganesh, Ravindra [1 ]
Tulledge-Scheitel, Sidna [1 ]
Hanson, Sara N. [2 ]
Arndt, Lori L. [3 ]
Wilker, Caroline G. [4 ]
Razonable, Raymund R. [1 ]
机构
[1] Mayo Clin, Rochester, MN 55905 USA
[2] Mayo Clin Hlth Syst, Mankato, MN USA
[3] Mayo Clin Hlth Syst, Eau Claire, WI USA
[4] Mayo Clin Hlth Syst Franciscan Healthcare, La Crosse, WI USA
关键词
breakthrough COVID-19; casirivimab-imdevimab; hospitalization; SARS-CoV-2; vaccination;
D O I
10.1093/infdis/jiab570
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Breakthrough coronavirus disease 2019 (COVID-19) may occur in fully vaccinated persons. Methods. We assessed the clinical outcomes of breakthrough COVID-19 in fully vaccinated individuals. Results. In this cohort of 1395 persons (mean age, 54.3 years; 60% female; median body mass index, 30.7) who developed breakthrough COVID-19, there were 107 (7.7%) who required hospitalization by day 28. Hospitalization was significantly associated with the number of medical comorbidities. Antispike monoclonal antibody treatment was significantly associated with a lower risk of hospitalization (odds ratio, 0.227; 95% confidence interval, 0.128-0.403; P<.001). The number needed to treat (NNT) to prevent 1 hospitalization was 225 among the lowest risk patient group compared with NNT of 4 among those with highest numbers of medical comorbidity. Conclusions. Monoclonal antibody treatment is associated with reduced hospitalization in vaccinated high-risk persons with mild to moderate COVID-19.
引用
收藏
页码:598 / 602
页数:5
相关论文
共 14 条
[1]   An EUA for Bamlanivimab-A Monoclonal Antibody for COVID-19 (Reprinted from Medical Letter on Drugs and Therapeutics, vol 62, pg 185-186, 2020) [J].
不详 .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 325 (09) :880-881
[2]   Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine [J].
Baden, Lindsey R. ;
El Sahly, Hana M. ;
Essink, Brandon ;
Kotloff, Karen ;
Frey, Sharon ;
Novak, Rick ;
Diemert, David ;
Spector, Stephen A. ;
Rouphael, Nadine ;
Creech, C. Buddy ;
McGettigan, John ;
Khetan, Shishir ;
Segall, Nathan ;
Solis, Joel ;
Brosz, Adam ;
Fierro, Carlos ;
Schwartz, Howard ;
Neuzil, Kathleen ;
Corey, Larry ;
Gilbert, Peter ;
Janes, Holly ;
Follmann, Dean ;
Marovich, Mary ;
Mascola, John ;
Polakowski, Laura ;
Ledgerwood, Julie ;
Graham, Barney S. ;
Bennett, Hamilton ;
Pajon, Rolando ;
Knightly, Conor ;
Leav, Brett ;
Deng, Weiping ;
Zhou, Honghong ;
Han, Shu ;
Ivarsson, Melanie ;
Miller, Jacqueline ;
Zaks, Tal .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (05) :403-416
[3]   Covid-19 Breakthrough Infections in Vaccinated Health Care Workers [J].
Bergwerk, Moriah ;
Gonen, Tal ;
Lustig, Yaniv ;
Amit, Sharon ;
Lipsitch, Marc ;
Cohen, Carmit ;
Mandelboim, Michal ;
Gal Levin, Einav ;
Rubin, Carmit ;
Indenbaum, Victoria ;
Tal, Ilana ;
Zavitan, Malka ;
Zuckerman, Neta ;
Bar-Chaim, Adina ;
Kreiss, Yitshak ;
Regev-Yochay, Gili .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (16) :1474-1484
[4]   Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant [J].
Bernal, Jamie Lopez ;
Andrews, Nick ;
Gower, Charlotte ;
Gallagher, Eileen ;
Simmons, Ruth ;
Thelwall, Simon ;
Stowe, Julia ;
Tessier, Elise ;
Groves, Natalie ;
Dabrera, Gavin ;
Myers, Richard ;
Campbell, Colin N. J. ;
Amirthalingam, Gayatri ;
Edmunds, Matt ;
Zambon, Maria ;
Brown, Kevin E. ;
Hopkins, Susan ;
Chand, Meera ;
Ramsay, Mary .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (07) :585-594
[5]  
Bierle DM, 2021, J PRIM CARE COMMUNIT, V12
[6]  
CRFB, 2021, COVID DAT TRACK
[7]  
Ganesh R, 2021, J CLIN INVEST, V131
[8]   Real-World Clinical Outcomes of Bamlanivimab and Casirivimab-Imdevimab Among High-Risk Patients With Mild to Moderate Coronavirus Disease 2019 [J].
Ganesh, Ravindra ;
Philpot, Lindsey M. ;
Bierle, Dennis M. ;
Anderson, Ryan J. ;
Arndt, Lori L. ;
Arndt, Richard F. ;
Culbertson, Tracy L. ;
Borgen, Molly J. Destro ;
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. .
JOURNAL OF INFECTIOUS DISEASES, 2021, 224 (08) :1278-1286
[9]   Casirivimab-Imdevimab treatment is associated with reduced rates of hospitalization among high-risk patients with mild to moderate coronavirus disease-19 [J].
Razonable, Raymund R. ;
Pawlowski, Colin ;
O'Horo, John C. ;
Arndt, Lori L. ;
Arndt, Richard ;
Bierle, Dennis M. ;
Borgen, Molly Destro ;
Hanson, Sara N. ;
Hedin, Michelle C. ;
Lenehan, Patrick ;
Puranik, Arjun ;
Seville, Maria T. ;
Speicher, Leigh L. ;
Tulledge-Scheitel, Sidna M. ;
Venkatakrishnan, A. J. ;
Wilker, Caroline G. ;
Badley, Andrew D. ;
Ganesh, Ravindra .
ECLINICALMEDICINE, 2021, 40
[10]   A Framework for Outpatient Infusion of Antispike Monoclonal Antibodies to High-Risk Patients with Mild-to-Moderate Coronavirus Disease-19: The Mayo Clinic Model [J].
Razonable, Raymund R. ;
Aloia, Nicole C. E. ;
Anderson, Ryan J. ;
Anil, Gokhan ;
Amdt, Lori L. ;
Amdt, Richard F. ;
Ausman, Sara E. ;
Bell, Sarah J. ;
Bierle, Dennis M. ;
Billings, Marcie L. ;
Bishop, Rachel K. ;
Cramer, Carl H. ;
Culbertson, Tracy L. ;
Dababneh, Ala S. ;
Derr, Amber N. ;
Epps, Kevin ;
Flaker, Susan M. ;
Ganesh, Ravindra ;
Gilmer, Mary A. ;
Urena, Eric Gomez ;
Gulden, Christopher R. ;
Haack, Tamara L. ;
Hanson, Sara N. ;
Herzog, Jenna R. ;
Heyliger, Alexander ;
Hokanson, Lex D. ;
Hopkins, Laura H. ;
Horecki, Richard J. ;
Krishna, Bipinchandra Hirisave ;
Huskins, W. Charles ;
Jackson, Tammy A. ;
Johnson, Ryan R. ;
Jorgenson, Betty ;
Kudma, Cory ;
Kennedy, Brian D. ;
Klingspom, Mary K. ;
Kottke, Brian ;
Larsen, Jennifer J. ;
Lessard, Sarah R. ;
Lutwick, Larry I. ;
Malone, Edward J., III ;
Matoush, Jennifer A. ;
Micallef, Ivana N. ;
Moehnke, Darcie E. ;
Mohamed, Muhanad ;
Ness, Colleena N. ;
Olson, Shelly M. ;
Orenstein, Robert ;
Palraj, Raj ;
Patel, Janki .
MAYO CLINIC PROCEEDINGS, 2021, 96 (05) :1250-1261