Simeunovic Gordana, Polega James, Toor Subhan, Andersen Nicholas J
Community Response Department, Spectrum Health, Grand Rapids, MI 49503, USA.
Department of Infectious Disease, Spectrum Health, Grand Rapids, MI 49503, USA.
Vaccines (Basel). 2023 Mar 17;11(3):688. doi: 10.3390/vaccines11030688.
Strategies to combat COVID-19 include vaccines and Monoclonal Antibody Therapy. While vaccines aim to prevent development of symptoms, Monoclonal Antibody Therapy aims to prevent the progression of mild to severe disease. An increasing number of COVID-19 infections in vaccinated patients raised the question of whether vaccinated and unvaccinated COVID-19 positive patients respond differently to Monoclonal Antibody Therapy. The answer can help prioritize patients if resources are scarce. We performed a retrospective study to evaluate and compare the outcomes and risks for disease progression between vaccinated and unvaccinated COVID-19 patients treated with Monoclonal Antibody Therapy by measuring the number of Emergency Department visits and hospitalizations within 14 days as well as the progression to severe disease, defined through the Intensive Care Unit admissions within 14 days, and death within 28 days from the Monoclonal Antibody infusion. From 3898 included patients, 2009 (51.5%) were unvaccinated at the time of Monoclonal Antibody infusion. Unvaccinated patients had more Emergency Department visits (217 vs. 79, < 0.0001), hospitalizations (116 vs. 38, < 0.0001), and progression to severe disease (25 vs. 19, = 0.016) following treatment with Monoclonal Antibody Therapy. After adjustment for demographics and comorbidities, unvaccinated patients were 2.45 times more likely to seek help in the Emergency Department and 2.70 times more likely to be hospitalized. Our data suggest the added benefit between the COVID-19 vaccine and Monoclonal Antibody Therapy.
抗击新冠病毒的策略包括疫苗和单克隆抗体疗法。疫苗旨在预防症状的出现，而单克隆抗体疗法旨在防止轻症发展为重症。接种疫苗的患者中新冠病毒感染病例越来越多，这引发了一个问题，即接种疫苗和未接种疫苗的新冠病毒阳性患者对单克隆抗体疗法的反应是否不同。如果资源稀缺，这个答案有助于确定患者的优先顺序。我们进行了一项回顾性研究，通过测量14天内的急诊科就诊次数和住院次数，以及14天内进入重症监护病房（定义为病情进展为重症）和单克隆抗体输注后28天内的死亡情况，来评估和比较接受单克隆抗体疗法的接种疫苗和未接种疫苗的新冠病毒患者疾病进展的结果和风险。在纳入的3898名患者中，2009名（51.5%）在接受单克隆抗体输注时未接种疫苗。接受单克隆抗体疗法治疗后，未接种疫苗的患者有更多的急诊科就诊（217次对79次，<0.0001）、住院（116次对38次，<0.0001）以及病情进展为重症（25例对19例，=0.016）。在对人口统计学和合并症进行调整后，未接种疫苗的患者到急诊科寻求帮助的可能性高2.45倍，住院的可能性高2.70倍。我们的数据表明了新冠病毒疫苗和单克隆抗体疗法之间的附加益处。
