A multimodal strategy to improve race/ethnic group equity in administration of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Lindsey E Fish; Tiffany Bendelow; Sarah Gardiner; Matthew K Wynia; Bethany M Kwan; Mika K Hamer; Adit A Ginde; Rebecca Hanratty

doi:10.1017/cts.2022.526

A multimodal strategy to improve race/ethnic group equity in administration of neutralizing monoclonal antibody treatment for COVID-19 outpatients

J Clin Transl Sci. 2023 Feb 10;7(1):e37. doi: 10.1017/cts.2022.526. eCollection 2023.

Authors

Lindsey E Fish¹, Tiffany Bendelow², Sarah Gardiner³, Matthew K Wynia⁴, Bethany M Kwan⁵, Mika K Hamer⁶, Adit A Ginde⁵, Rebecca Hanratty¹

Affiliations

¹ Division of General Internal Medicine, Denver Health and Hospital and University of Colorado School of Medicine, Denver, USA.
² Department of Medicine, Denver Health and Hospital, Denver, USA.
³ Denver Health and Hospital, Denver, USA.
⁴ Department of Internal Medicine, University of Colorado School of Medicine, Aurora, USA.
⁵ Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, USA.
⁶ Department of Health Systems, Management, and Policy, Colorado School of Public Health, Aurora, USA.

Abstract

Introduction: Racial and ethnic minority groups have higher rates of SARS-CoV-2 infection, severe illness, and death; however, they receive monoclonal antibody (mAb) treatment at lower rates than non-Hispanic White patients. We report data from a systematic approach to improve equitable provision of COVID-19 neutralizing monoclonal antibody treatment.

Methods: Treatment was administered at a community health urgent care clinic affiliated with a safety-net urban hospital. The approach included a stable treatment supply, a same-day test and treat model, a referral process, patient outreach, and financial support. We analyzed the race/ethnicity data descriptively and compared proportions using a chi-square test.

Results: Over 17 months, 2524 patients received treatment. Compared to the demographics of county COVID-19-positive cases, a greater proportion of patients who received mAb treatment were Hispanic (44.7% treatment vs. 36.5% positive cases, p < 0.001), a lower proportion were White Non-Hispanic (40.7% treatment vs. 46.3% positive cases, p < 0.001), equal proportion were Black (8.2% treatment vs. 7.4% positive cases, P = 0.13), and equal proportion occurred for other race patients.

Discussion: Implementation of multiple systematic strategies to administer COVID-19 monoclonal antibodies resulted in an equitable race/ethnic distribution of treatment.

Keywords: COVID-19; SARS-CoV-2 monoclonal antibodies; community-based; health equity; race/ethnic disparity.