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Published on: April 6, 2019
Bamlanivimab Reduces ED Returns and Hospitalizations and May Reduce COVID-19 Burden on Low-resource Border Hospitals
Faith C Quenzer1,2,3, Andrew T Lafree2,3, Londyn Grey4
1San Diego State University School of Public Health, San Diego, California.
Insights
Bamlanivimab significantly reduced emergency department (ED) return visits and hospitalizations for COVID-19 patients, particularly within the Latinx/Hispanic population. This monoclonal antibody treatment offers a promising strategy to decrease hospital utilization during surges.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant public health challenge, especially in resource-limited settings.
- Identifying effective treatments to reduce hospitalizations and emergency department (ED) visits is crucial for managing COVID-19 surges.
- The Latinx/Hispanic population in the U.S.-Mexico border region faces unique healthcare access challenges during the pandemic.
Purpose of the Study:
- To evaluate the effectiveness of bamlanivimab in reducing ED return visits for mild-to-moderate COVID-19.
- To assess bamlanivimab's impact on preventing subsequent hospitalizations and deaths.
- To analyze treatment outcomes in a predominantly Latinx/Hispanic population at a border hospital.
Main Methods:
- Retrospective, open-label interventional study of 270 adult patients with SARS-CoV-2 infection.
- Comparison of outcomes between patients receiving bamlanivimab (exposed) and those not receiving it (unexposed).
- Analysis of 14-day ED return visits and hospitalizations using chi-square tests and multivariate regression.
Main Results:
- Bamlanivimab administration was associated with a significant risk reduction in ED return visits (84.4% absolute reduction) and hospitalizations (96.2% absolute reduction) within 14 days.
- The study included 136 exposed and 134 unexposed patients, with 91.5% identifying as Latinx/Hispanic.
- Adjusted analyses accounted for comorbidities such as chronic kidney disease and diabetes.
Conclusions:
- Bamlanivimab infusions substantially reduced ED return visits and hospitalizations in high-risk COVID-19 patients, especially in the Latinx/Hispanic demographic.
- Monoclonal antibody therapy presents a viable strategy to mitigate hospital resource utilization during COVID-19 outbreaks.
- Findings support the use of bamlanivimab in border hospitals to manage COVID-19 patient flow and outcomes.
Introduction:
To evaluate the effectiveness of bamlanivimab at reducing return emergency department (ED) visits in primarily Latinx/Hispanic patients with mild or moderate coronavirus disease 2019 (COVID-19). Secondary aims were to evaluate the prevention of subsequent hospitalizations and deaths in a resource-limited United States (U.S.)-Mexico border hospital.
Methods:
We conducted a retrospective, open-label interventional study on 270 eligible adult patients diagnosed with mild-moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who met criteria for receiving bamlanivimab from November 1, 2020 to January 31, 2021. The main outcomes of 14-day return visits to the ED and hospitalizations due to COVID-19 were compared between two groups - those who received bamlanivimab (exposed group) and those who did not receive bamlanivimab (unexposed group). Outcomes were analyzed through chi-square tests followed by multivariate regression modeling to adjust for patient demographics, characteristics, and comorbidities.
Results:
There were 136 COVID-19 patients who received bamlanivimab in the ED prior to discharge and an unexposed group of 134 COVID-19 patients who were evaluated and discharged from the ED without receiving bamlanivimab. Overall, mean age was 61.7 (S.D. +/-13.9) years, mean body mass index (BMI) 31.0 (S.D. +/-6.6) kg/m2, 91.5% identified as Latinx/Hispanic, 51.9% male, and 80.7% reported at least one comorbidity. Most commonly reported comorbidities were obesity (22.6%), hypertension (59.6%), and diabetes (41.1%). The bamlanivimab group had a 22.8% (mean estimate = 0.7717, 95% CI [0.6482, 0.8611]) risk reduction or 84.4% (0.3030, 95% CI = 0.166, 0.554, p=.0001) absolute reduction of ED return visits within 14 days compared to controls after adjusting for chronic kidney disease. The bamlanivimab group had 19.0% (mean estimate=0.8097, 95% CI [0.6451, 0.9087]) risk reduction or 96.2% (0.235, 95% CI 0.100, 0.550, p=0.0008) absolute reduction of subsequent hospitalizations compared to unexposed patients after adjusting for diabetes status.
Conclusion:
Bamlanivimab infusions for high-risk COVID-19 patients in the ED substantially reduced the risk of return visits to the ED and hospitalizations in our primarily Latinx/Hispanic population. Monoclonal antibody infusions may help reduce hospital utilization during COVID-19 surges at U.S.-Mexico border hospitals.
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