在熟练护理设施中,SARS-CoV-2-中和单克隆抗体的不足使用
Catharine I Paules1, Nicole Osevala2, Erik Lehman3
1Division of Infectious Diseases, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
Journal of the American Medical Directors Association
|November 9, 2023
概括
针对COVID-19的单克隆抗体 (mab) 用量在高风险组的熟练护理机构 (SNF) 中较低. 微型城市设施的使用率更高,这凸显了需要改善弱势群体的交通便利性.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 老年医学 老年医学
背景情况:
- 熟练护理设施 (SNFs) 是COVID-19并发症的高风险环境.
- 在SNF中部署SARS-CoV-2中和性单克隆抗体 (mabs) 尚不清楚.
- 有效的MAB利用对于减轻老年人和弱势群体的严重COVID-19结果至关重要.
研究的目的:
- 评估在熟练护理机构 (SNFs) 中用于COVID-19治疗的单克隆抗体 (mabs) 的利用情况.
- 确定与SNF有效使用mab相关的设施特征.
- 了解高风险人群中mab分布的障碍.
主要方法:
- 对参与ECHO项目的130个美国国家无线网络基金进行了回顾性队列研究.
- 评估了每例COVID-19病例中注射的Mabs的百分比作为主要结果.
- 使用顺序逻辑回归来将SNF特征 (位置,人员,疫苗接种率) 与mab利用率相关联.
主要成果:
- 平均药物利用率为12.96%,超过50%的设施使用零剂量.
- 与大都市设施相比,微型城市设施的马布使用率更高 (P=.012).
- 在较少的人员短缺的设施中,观察到越来越多的mab使用趋势.
结论:
- 在SNFs中,COVID-19单克隆抗体显著未得到充分利用,SNFs是一个面临严重后果高风险的人群.
- 设施的位置,特别是在微型城市地区,与马布利用率的增加有关.
- 解决MAB分布障碍对于未来的流行病准备和保护弱势居民至关重要.
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