• James D Melton, Kayla Wilson, Fred Blind, Andrew Barbera, Donna Bhisitkul, Shannon Hasara, Karen Homa, Juliana Karp, Hal Escowitz, Todd Haber, Diana DeGroot, Jonathan Anderson, Jason DeLeon, Jesse De Los Santos, Donna Faviere, Joanne Fuell, Rita Gillespie, Jesse Glueck, Cliff Reeber, David J Rhodes, and Vashun Rodriguez.
• Department of Emergency Medicine, Lakeland Regional Health, Lakeland, FL, USA.
• Am J Emerg Med. 2021 Dec 1; 50: 437441437-441.

BackgroundRecombinant monoclonal antibody therapies have been utilized under emergency use authorization (EUA) for the prevention of clinical decompensation in high-risk COVID-19 positive patients for up to 10 days from symptom onset. The purpose of this study was to determine the impact of the timing of the monoclonal antibody, bamlanivimab, on clinical outcomes in high-risk COVID-19 positive patients.MethodsThis was an IRB-approved, retrospective evaluation of adult patients who received bamlanivimab per EUA criteria in the emergency department (ED). Patients were dichotomized into two groups- 3 days of symptoms or less (early) versus 4 to 10 days (late). The primary outcome was hospitalization for COVID-related illness at 28 days (or treatment failure). Secondary outcomes were COVID-related ED visits at 28 days, hospital and intensive care unit (ICU) length of stay (LOS), and in-hospital mortality at 28 days.ResultsA total of 839 patients were included in the analysis. There was no difference observed in COVID-related hospitalization rates within 28 days between the early and late bamlanivimab administration groups (7.5% vs. 8.2%, p = 0.71). There was no difference in COVID-related ED visits within 28 days with 13% of patients returning to the ED.ConclusionsIn conclusion, there were no differences in the rates of hospitalization at 28 days when bamlanivimab was administered in the first 3 days of illness versus days 4 to 10. Future prospective studies are warranted to expand upon the characteristics of patients that may or may not benefit from monoclonal antibody therapy.Copyright © 2021 Elsevier Inc. All rights reserved.

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