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Implementation and Patient Outcomes of a Pediatric COVID-19 Monoclonal Antibody Program

Jill E Blind1, Matt Sapko1, Alex Killough1

  • 1Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio, USA.

Journal of the Pediatric Infectious Diseases Society
|October 6, 2022
PubMed
Abstract

Insights

A tiered system for monoclonal antibody (mAb) therapy allocation in pediatric COVID-19 patients was implemented. This process facilitated efficient distribution and provided insights into clinical outcomes for young individuals receiving these treatments.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunotherapy
  • Public Health

Background:

  • The COVID-19 pandemic necessitated rapid development of therapeutic strategies, including monoclonal antibodies (mAbs).
  • Limited data previously advised against routine use of COVID-19 mAbs in pediatric populations, emphasizing individualized risk assessment.
  • This study details the implementation of a mAb referral process and evaluates clinical outcomes in a pediatric hospital setting.

Purpose of the Study:

  • To describe the implementation of a standardized monoclonal antibody (mAb) referral process for pediatric patients with COVID-19.
  • To assess the clinical outcomes of pediatric patients who received mAb infusions for treatment or post-exposure prophylaxis.
  • To evaluate the effectiveness of a tiered allocation system for mAb therapies in a pediatric hospital.

Main Methods:

  • A tiered allocation system was developed based on underlying medical conditions for COVID-19 mAb therapy.
  • A standardized referral and approval process was integrated for mAb administration.
  • Clinical data, including demographics, medical conditions, and disease course, were collected for 182 pediatric patients (≤21 years) receiving mAb infusions.

Main Results:

  • A total of 182 pediatric patients received monoclonal antibody (mAb) infusions between November 2020 and January 2022.
  • The median age of patients receiving mAb therapy was 15 years, with a range from 10 months to 21 years.
  • Adverse reactions during infusion were reported in 4% of patients, and 8% required a COVID-19-related visit within 30 days post-infusion.

Conclusions:

  • A tiered allocation process can effectively stratify and distribute monoclonal antibody (mAb) therapies in pediatric settings.
  • Further research is needed on mAb efficacy, standardized prioritization, and optimal timing for pediatric COVID-19 treatment.
  • The findings support the development of frameworks for equitable and efficient access to mAb therapies for children and adolescents.
Keywords:
COVID-19SARS-CoV-2 neutralizing antibodybamlanivimabcasirivimabpediatricsotrovimab

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