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

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Dennis M Bierle1, Ravindra Ganesh1, Sidna Tulledge-Scheitel1

  • 1Mayo Clinic, Rochester, Minnesota, USA.

The Journal of Infectious Diseases
|November 18, 2021
PubMed

Insights

Fully vaccinated individuals can experience breakthrough COVID-19. Monoclonal antibody treatment significantly reduced hospitalization risk in high-risk vaccinated patients with mild to moderate COVID-19.

Area of Science:

  • Infectious Diseases
  • Vaccinology
  • Immunology

Background:

  • Breakthrough coronavirus disease 2019 (COVID-19) is possible in fully vaccinated individuals.
  • Understanding clinical outcomes in this population is crucial for public health management.

Purpose of the Study:

  • To assess the clinical outcomes of breakthrough COVID-19 in fully vaccinated individuals.
  • To identify factors associated with hospitalization and the effectiveness of treatments.

Main Methods:

  • A cohort study of 1395 fully vaccinated individuals who developed COVID-19.
  • Analysis of hospitalization rates by day 28.
  • Evaluation of the association between medical comorbidities and hospitalization.
  • Assessment of antispike monoclonal antibody treatment efficacy.

Main Results:

  • 7.7% of vaccinated individuals required hospitalization by day 28.
  • Hospitalization risk was significantly associated with the number of medical comorbidities.
  • Antispike monoclonal antibody treatment was linked to a substantially lower risk of hospitalization (OR, 0.227; P < .001).
  • The number needed to treat (NNT) to prevent one hospitalization varied significantly by comorbidity status.

Conclusions:

  • Monoclonal antibody treatment demonstrates significant benefit in reducing hospitalization among vaccinated high-risk individuals with mild to moderate COVID-19.
  • Comorbidity status is a key determinant of hospitalization risk in vaccinated breakthrough cases.
Abstract

Keywords:
SARS-CoV-2breakthrough COVID-19casirivimab-imdevimabhospitalizationvaccination

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