Treatment of SARS-CoV-2 Infection During Pregnancy with Monoclonal Antibodies

Below is a summary of “Monoclonal Antibodies for the Treatment of SARS-CoV-2 Infection During Pregnancy” published in the December 2022 issue. internal medicine by McCreary, et al.

In high-risk outpatients with mild to moderate COVID-19, monoclonal antibody (mAb) treatment reduces the risk of hospitalization and death. However, no trials have compared the safety and efficacy of mAb therapy with placebo in pregnant women. The purpose of this study was to compare the incidence of drug-related adverse events and obstetric-related safety outcomes between pregnant women who received and did not receive mAb treatment, and to assess the combined incidence of mAb treatment, hospitalization, and ED. was to examine the correlation between Hospital visit, delivery, or death within 28 days of her COVID-19 diagnosis. Cohort studies look at historical data and pair individuals based on propensity scores. From April 30, 2021 to January 21, 2022, visit UPMC’s Health System. SARS-CoV-2-positive pregnant women or women with a history of SARS-CoV-2 infection (12 years and older) (polymerase chain reaction or antigen test).

Compared with no mAb treatment, interventions containing bamranibimab and etesevimab, casilibimab and imdevimab, or sotrovimab had better outcomes. Drug-related adverse events, obstetric-related safety outcomes for women who gave birth, and a risk-adjusted composite of hospitalization or ED visit, delivery, or death within 28 days of infection with COVID-19 were all outcome measures. was included as Approximately 552 of 944 pregnant women (median age) [IQR]30 [26 to 33]; White (79.5%; n = 750); Median Charlson Comorbidity Index score [IQR]0 [0 to 0]) received mAb therapy (58%). The most common treatment was sotrovimab (69%), with a median gestational age of 179 days (IQR, 123–227) at diagnosis or treatment of COVID-19. Approximately 62% (392) of vaccination coverage was included among those with known vaccination status. Only 8 of her women (1.4%) experienced drug-related adverse events, and there were no significant differences in obstetric-related outcomes among the remaining 778 women of hers. For her 28-day combined outcome related to COVID-19, the risk ratio for mAb therapy was 0.71 (95% CI, 0.37–1.4) in the overall population. The risk ratio was 0.61 (95% CI: 0.34 to 1.1) after adjusting for propensity scores. Patients treated with mAbs had a 100% survival rate, whereas the control group had a 100% mortality rate (1 death). Propensity score concordance was 2.5% in the mAb-treated group vs. 2% in the untreated group (risk ratio 1.3; 95% CI 0.58% to 2.8%), but there was no difference in the discordant cohort (14 [2.5%] versus two [0.5%]risk ratio, 5.0; 95% CI, 1.1–21.7).

Drug-related adverse events are reported by patients and health care providers, which may lead to underestimation of actual incidence. Severity could not be determined. The incidence of serious side effects following her mAb treatment for pregnant women with mild to moderate COVID-19 was low and generally mild. There were no discernible differences in obstetric-related safety outcomes when comparing those who gave birth after receiving mAb treatment with those who did not. Comparing her mAb treatment with her no mAb treatment in groups with similar propensity scores, there was no change in her COVID-19-related outcome or hospitalization for reasons other than COVID-19 over 28 days.


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