Implementation of a Collaborated Antimicrobial Stewardship Program and Outpatient Parenteral Antimicrobial Therapy (OPAT) Unit-driven Monoclonal Antibody Therapy Program for COVID-19 at a NYC Hospital.

Overview

OBJECTIVES: To assess the processes and clinical outcomes of a joint collaboration between Antimicrobial Stewardship Program (ASP) and the Outpatient Parenteral Antimicrobial Therapy (OPAT) unit for delivery of monoclonal antibody therapy for mild-to-moderate COVID-19. METHODS: We carried out a retrospective, interim analysis of our COVID-19 monoclonal antibody therapy program. Outcomes included clinical response, incidence of hospitalization, and adverse events. RESULTS: 175 patients (casirivimab-imdevimab, n=130; bamlanivimab, n=45) were treated between Dec 2020 and Mar 1, 2021. The median time from symptom onset was 6 (IQR 4,8) days at time of treatment. Of 135 patients available for follow up, 71.9% and 85.9% of patients reported symptom improvement within 3 and 7 days of treatment, respectively. Nine (6.7%) patients required a COVID-19 related hospitalization within 14 days of treatment for progression of symptoms. Seven (4%) patients experienced an infusion-related reaction. CONCLUSIONS: An ASP-OPAT collaboration is a novel approach to implement an efficient and safe monoclonal antibody therapy program for the treatment of mild-to-moderate COVID-19.