Does monoclonal antibody treatment for COVID-19 impact short and long-term outcomes in a large generalisable population? A retrospective cohort study in the USA

BMJ Open. 2023 Aug 8;13(8):e069247. doi: 10.1136/bmjopen-2022-069247.

Abstract

Objectives: To explore whether monoclonal antibodies (MAb) administered to high-risk patients with COVID-19 during the first week of illness prevent postacute sequelae of SARS-CoV-2 infection.

Design: Retrospective cohort study.

Setting: USA.

Participants: A sample of 3809 individuals who received MAbs and a matched one-to-one comparison group from a set of 327 079 eligible patients who did not receive MAb treatment were selected from a deidentified administrative data set from commercial and Medicare Advantage health plan enrollees in the USA, including claims and outpatient laboratory data.

Results: Individuals who received MAb were 28% less likely to be hospitalised (HR=0.72, 95% CI 0.58 to 0.89) and 41% less likely to be admitted to the intensive care unit (HR=0.59, 95% CI 0.38 to 0.89) 30 days from SARS-CoV-2 diagnosis compared with individuals who did not receive MAb. A higher proportion of individuals given MAb therapy received care for clinical sequelae in the postacute phase (p=0.018).

Conclusions: While MAb therapy was associated with benefits in the acute period, the benefit of therapy did not extend into the postacute period and did not reduce risk for clinical sequelae.

Keywords: COVID-19; infectious diseases; virology.

MeSH terms

  • Aged
  • Antibodies, Monoclonal / therapeutic use
  • COVID-19 Testing
  • COVID-19*
  • Disease Progression
  • Humans
  • Medicare
  • Retrospective Studies
  • SARS-CoV-2
  • United States / epidemiology

Substances

  • Antibodies, Monoclonal