Xu Yonghao, Liu Ying, Zheng Ruiqiang, Si Shujie, Xi Yin, Deng Xilong, Wang Gang, Zhou Liang, Li Manshu, Wang Ya, Zhang Shuo, Xie Jianfeng, Liu Xiaoqing, Yang Yi, Tang Xiaoping
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Institute of Respiratory and Health, Guangzhou, China.
Intensive Care Res. 2023 Jun 5:1-9. doi: 10.1007/s44231-023-00040-9.
Early intervention with neutralizing antibodies is considered to be effective in preventing disease progression in patients with mild to moderate COVID-19 infection. Elderly patients are the most susceptible and at a higher risk of COVID-19 infection. The present study aimed to assess the necessity and possible clinical benefits of the early administration of Amubarvimab/Romlusevimab (BRII-196/198) in the elderly population.
The present study was designed as a retrospective, multi-center cohort study conducted with 90 COVID-19 patients aged over 60, who were divided into two groups based on the timing of the administration of BRII-196/198 (administration at ≤ 3 days or > 3 days from the onset of infection symptoms).
The ≤ 3 days group exhibited a greater positive effect (HR 5.94, 95% CI, 1.42-24.83; < 0.01), with only 2 patients among 21 patients (9.52%) exhibiting disease progression, compared to the 31 patients among the 69 patients (44.93%) of the > 3 days group who exhibited disease progression. The multivariate Cox regression analysis revealed low flow oxygen support prior to BRII-196/198 administration (HR 3.53, 95% CI 1.42-8.77, < 0.01) and PLT class (HR 3.68, 95% CI 1.37-9.91, < 0.01) as independent predictors of disease progression.
In elderly patients with mild or moderate COVID-19 disease, who do not require oxygen support and had the risk factors for disease progression to severe COVID-19 disease, the administration of BRII-196/198 within 3 days resulted in a beneficial trend in terms of preventing disease progression.
早期使用中和抗体进行干预被认为对预防轻至中度新型冠状病毒肺炎（COVID-19）感染患者的疾病进展有效。老年患者是最易感染且感染COVID-19风险较高的人群。本研究旨在评估在老年人群中早期给予安巴韦单抗/罗米司韦单抗（BRII-196/198）的必要性及可能的临床益处。
本研究设计为一项回顾性、多中心队列研究，纳入90例年龄超过60岁的COVID-19患者，根据BRII-196/198的给药时间（感染症状出现后≤3天或>3天给药）将患者分为两组。
≤3天组显示出更大的积极效果（风险比5.94，95%置信区间1.42 - 24.83；P<0.01），21例患者中有2例（9.52%）出现疾病进展，而>3天组的69例患者中有31例（44.93%）出现疾病进展。多因素Cox回归分析显示，在给予BRII-196/198之前接受低流量氧疗（风险比3.53，95%置信区间1.42 - 8.77，P<0.01）和血小板分级（风险比3.68，95%置信区间1.37 - 9.91，P<0.01）是疾病进展的独立预测因素。
对于轻度或中度COVID-19疾病且不需要氧疗但有疾病进展为重症COVID-19疾病风险因素的老年患者，在3天内给予BRII-196/198在预防疾病进展方面呈现出有益趋势。
