Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
Department of Medicine, Optum Health, Eden Prairie, Minnesota, USA.
BMJ Open. 2023 Aug 8;13(8):e069247. doi: 10.1136/bmjopen-2022-069247.
To explore whether monoclonal antibodies (MAb) administered to high-risk patients with COVID-19 during the first week of illness prevent postacute sequelae of SARS-CoV-2 infection.
Retrospective cohort study.
USA.
A sample of 3809 individuals who received MAbs and a matched one-to-one comparison group from a set of 327 079 eligible patients who did not receive MAb treatment were selected from a deidentified administrative data set from commercial and Medicare Advantage health plan enrollees in the USA, including claims and outpatient laboratory data.
Individuals who received MAb were 28% less likely to be hospitalised (HR=0.72, 95% CI 0.58 to 0.89) and 41% less likely to be admitted to the intensive care unit (HR=0.59, 95% CI 0.38 to 0.89) 30 days from SARS-CoV-2 diagnosis compared with individuals who did not receive MAb. A higher proportion of individuals given MAb therapy received care for clinical sequelae in the postacute phase (p=0.018).
While MAb therapy was associated with benefits in the acute period, the benefit of therapy did not extend into the postacute period and did not reduce risk for clinical sequelae.
探讨 COVID-19 高危患者在发病的第一周内使用单克隆抗体（MAb）是否能预防 SARS-CoV-2 感染的急性后期后遗症。
回顾性队列研究。
美国。
从美国商业和医疗保险优势健康计划参保者的匿名行政数据集中选择了一个样本，其中包括索赔和门诊实验室数据，该样本包含了 3809 名接受 MAb 治疗的个体和一组 327079 名符合条件但未接受 MAb 治疗的个体，进行了一对一匹配。
与未接受 MAb 的个体相比，接受 MAb 的个体在 SARS-CoV-2 诊断后 30 天住院的可能性降低了 28%（HR=0.72，95%CI 0.58 至 0.89），入住重症监护病房的可能性降低了 41%（HR=0.59，95%CI 0.38 至 0.89）。接受 MAb 治疗的个体中有更高比例的人在急性后期需要接受临床后遗症的治疗（p=0.018）。
尽管 MAb 治疗在急性期有一定的益处，但治疗的益处并没有延伸到急性后期，也没有降低临床后遗症的风险。
