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. 2023 Apr:129:260-265.
doi: 10.1016/j.ijid.2023.01.012. Epub 2023 Jan 21.

SARS-CoV-2 neutralizing antibody therapies: an early retrospective cohort study of 26 hospitalized patients treated with bamlanivimab or casirivimab/imdevimab

Martin Heller  1 , Clara Henrici  2 , Judith Büttner  2 , Sebastian Leube  3 , Isabelle Treske  3 , Petra Pospischil  2 , Michael Doll  2 , Ilka Schanz  4 , Agnes Hallier  5 , Eva Herrmann  6 , Michael Schmidt  7 , Christoph Sarrazin  2
Affiliations

SARS-CoV-2 neutralizing antibody therapies: an early retrospective cohort study of 26 hospitalized patients treated with bamlanivimab or casirivimab/imdevimab

Martin Heller et al. Int J Infect Dis. 2023 Apr.

Abstract

Objectives: In this early retrospective cohort study, a total of 26 patients with SARS-CoV-2 were treated with bamlanivimab or casirivimab/imdevimab, and the reduction of the viral load associated with the developed clinical symptoms was analyzed.

Methods: Patients in the intervention groups received bamlanivimab or casirivimab/imdevimab. Patients without treatment served as control. Outcomes were assessed by clinical symptoms and change in log viral load from baseline based on the cycle threshold over a period of 18 days.

Results: Median log viral load decline was higher in both intervention groups after 3 and 6 days compared to control. However, at later time points, the decline of the viral load was more distinct in the control group. Mild symptoms of COVID-19 were observed in 6.3% of the intervention groups and in no patient of the control. No patients treated with bamlanivimab, 18.8% treated with casirivimab/imdevimab, and 14.2% in the control group developed moderate symptoms. Severe symptoms were recorded only in the control group (14.2%), including one related death.

Conclusion: Treatment with monoclonal SARS-CoV-2 antibodies seems to accelerate decline of virus loads, especially in the first 6 days after administration, compared to control. This may be associated with a reduced likeliness of a severe course of COVID-19.

Keywords: Antibody therapy; Bamlanivimab; COVID-19; Casirivimab; Imdevimab; Viral load.

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Conflict of interest statement

Declaration of competing interest The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Flow chart of the study design.
Figure 2
Figure 2
Change of log viral load from baseline after 3, 6, 9, 12, 15, and 18 days. The boxes represent the interquartile range with the mean values (squares). The dots outside the boxes represent the observed values outside the range. After day 3 and 6 the change in log viral load from baseline is highest after the treatment with both antibody therapies. Only for the therapy with bamlanivimab after 3 days a statistically significant difference can be observed compared to the control group with a P-value of 0.01 (95% confidence interval, 0.60 to 4.22). Due to earlier discharge of patients and one death case in the control group, the number of measurements declined over time and only two patients could be included at day 15 and 18.
Figure 3
Figure 3
(a) Single cycle threshold values of every patient as change in viral load after 3, 6, 9, 12, 15, and 18 days for the treatment with bamlanivimab (red line) compared to no treatment (gray line). The CT value is defined as number of cycles that are necessary to generate a fluorescent signal during a polymerase chain reaction that exceeds a critical threshold such as the background signal. Because the generated signals are inversely proportional to the copy number of the coronavirus, it can be used as indirect measure for the viral load and thus for the potential to develop a severe SARS-CoV-2 infection. (b) Mean CT values as change in viral load after 3, 6, 9, 12, 15, and 18 days for the treatment with bamlanivimab (red dashed line) compared to no treatment (gray line). CT, cycle threshold.
Figure 4
Figure 4
(a) Single CT values of every patient as change in viral load after 3, 6, 9, 12, 15, and 18 days for the treatment with casirivimab/imdevimab (blue line) compared to no treatment (gray line). The CT value is defined as number of cycles that are necessary to generate a fluorescent signal during a polymerase chain reaction that exceeds a critical threshold such as the background signal. Because the generated signals are inversely proportional to the copy number of the coronavirus, it can be used as indirect measure for the viral load and thus for the potential to develop a severe SARS-CoV-2 infection. (b) Mean CT values as change in viral load after 3, 6, 9, 12, 15, and 18 days for the treatment with casirivimab/imdevimab (blue dashed line) compared to no treatment (gray line). CT, cycle threshold.
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References

    1. Tabata S, Imai K, Kawano S, Ikeda M, Kodama T, Miyoshi K, et al. Clinical characteristics of COVID-19 in 104 people with SARS-CoV-2 infection on the Diamond Princess cruise ship: a retrospective analysis. Lancet Infect Dis. 2020;20:1043–1050. doi: 10.1016/S1473-3099(20)30482-5. - DOI - PMC - PubMed
    1. Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. 2020;58:299–301. doi: 10.4193/Rhin20.114. - DOI - PubMed
    1. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277:2251–2261. doi: 10.1007/s00405-020-05965-1. - DOI - PMC - PubMed
    1. Berlin DA, Gulick RM, Martinez FJ. Severe COVID-19. N Engl J Med. 2020;383:2451–2460. doi: 10.1056/NEJMcp2009575. - DOI - PubMed
    1. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of Covid-19 in New York City. N Engl J Med. 2020;382:2372–2374. doi: 10.1056/NEJMc2010419. - DOI - PMC - PubMed